Association of fever and severe clinical course in bronchiolitis

Little attention has been given to the relation between fever and the severity of bronchiolitis. Therefore, the relation between fever and the clinical course of 90 infants (59 boys, 31 girls) hospitalised during one season with bronchiolitis was studied prospectively. Fever (defined as a single recording > 38.0°C or two successive recording > 37.8°C) was present in 28 infants. These infants were older (mean age, 5.3 v 4.0 months), had a longer mean hospital stay (4.2 v2.7 days), and a more severe clinical course (71.0%v 29.0%) than those infants without fever. Radiological abnormalities (collapse/consolidation) were found in 60.7% of the febrile group compared with 14.8% of the afebrile infants. These results suggest that monitoring of body temperature is important in bronchiolitis and that fever is likely to be associated with a more severe clinical course and radiological abnormalities.

[Book review] Chance encounters: a first course in data analysis and inference

Book review of: Chance Encounters: A First Course in Data Analysis and Inference by Christopher J. Wild and George A.F. Seber 2000, John Wiley & Sons Inc. Hard-bound, xviii + 612 pp ISBN 0-471-32936-3

Scheduling batches with sequential job processing for two-machine flow and open shops

In this paper, we study a problem of scheduling and batching on two machines in a flow-shop and open-shop environment. Each machine processes operations in batches, and the processing time of a batch is the sum of the processing times of the operations in that batch. A setup time, which depends only on the machine, is required before a batch is processed on a machine, and all jobs in a batch remain at the machine until the entire batch is processed. The aim is to make batching and sequencing decisions, which specify a partition of the jobs into batches on each machine, and a processing order of the batches on each machine, respectively, so that the makespan is minimized. The flow-shop problem is shown to be strongly NP-hard. We demonstrate that there is an optimal solution with the same batches on the two machines; we refer to these as consistent batches. A heuristic is developed that selects the best schedule among several with one, two, or three consistent batches, and is shown to have a worst-case performance ratio of 4/3. For the open-shop, we show that the problem is NP-hard in the ordinary sense. By proving the existence of an optimal solution with one, two or three consistent batches, a close relationship is established with the problem of scheduling two or three identical parallel machines to minimize the makespan. This allows a pseudo-polynomial algorithm to be derived, and various heuristic methods to be suggested.

Non-preemptive two-machine open shop scheduling with non-availability constraints

We study a two-machine open shop scheduling problem, in which the machines are not continuously available for processing. No preemption is allowed in the processing of any operation. The objective is to minimize the makespan. We consider approximability issues of the problem with more than one non-availability intervals and present an approximation algorithm with a worst-case ratio of 4/3 for the problem with a single non-availability interval.

Effect of current stressing on the reliability of 63Sn37Pb solder joints

The effect of current stressing on the reliability of 63Sn37Pb solder joints with Cu pads was investigated at temperatures of −5 °C and 125 °C up to 600 h. The samples were stressed with 3 A current (6.0 × 102 A/cm2 in the solder joint with diameter of 800 μm and 1.7 × 104 A/cm2 in the Cu trace with cross section area of 35 × 500 μm). The temperatures of the samples and interfacial reaction within the solder joints were examined. The microstructural change of the solder joints aged at 125 °C without current flow was also evaluated for comparison. It was confirmed that the current flow could cause the temperature of solder joints to rise rapidly and remarkably due to accumulation of massive Joule heat generated by the Cu trace. The solder joints stressed at 125 °C with 3 A current had an extensive growth of Cu6Sn5 and Cu3Sn intermetallic compounds (IMC) at both top and bottom solder-to-pad interfaces. It was a direct result of accelerated aging rather than an electromigration or thermomigration effect in this experiment. The kinetic is believed to be bulk diffusion controlled solid-state reaction, irrespective of the electron flow direction. When stressed at −5 °C with 3 A current, no significant change in microstructure and composition of the solder joints had occurred due to a very low diffusivity of the atoms as most Joule heat was eliminated at low temperature. The IMC evolution of the solder joints aged at 125 °C exhibited a subparabolic growth behavior, which is presumed to be a combined mechanism of grain boundary diffusion and bulk diffusion. This is mainly ascribed to the retardant effect against the diffusion course by the sufficiently thick IMC layer that was initially formed during the reflow soldering.

Transporting jobs through a two-machine open shop

We consider the two-machine open shop scheduling problem in which the jobs are brought to the system by a single transporter and moved between the processing machines by the same transporter. The purpose is to split the jobs into batches and to find the sequence of moves of the transporter so that the time by which the completed jobs are collected together on board the transporter is minimal. We present a 7/5-approximation algorithm. © 2008 Wiley Periodicals, Inc. Naval Research Logistics 2009

The varieties of student experience - an open research question and some ways to answer it

Based on meetings of the Society for Research into Higher Education’s Student Experience Network over the past three years, the genuinely open research question is posed whether there is one or more undergraduate student experience within English higher education. Answering this question depends on whether what is taught or what is learnt is examined. If the latter, then a unitary student experience can be said to exist only in the narrowest of normative senses. What undergraduates actually learn – defined in the widest sense – is the $64,000 question of research on the student experience. Various ways to answer this question are proposed, including using students to research students. Conceptual tools to apply to findings can be developed from youth studies and cognate disciplines, particularly in relation to student identities and aspirations. Lastly, these proposals are placed in the wider context of comparative models of the varieties of student experience, including those emerging in the UK’s national regions.

A Competence-Based Course Authoring Concept for Learning Platforms with Legacy Assignment Tools

This paper is concerned with several of the most important aspects of Competence-Based Learning (CBL): course authoring, assignments, and categorization of learning content. The latter is part of the so-called Bologna Process (BP) and can effectively be supported by integrating knowledge resources like, e.g., standardized skill and competence taxonomies into the target implementation approach, aiming at making effective use of an open integration architecture while fostering the interoperability of hybrid knowledge-based e-learning solutions. Modern scenarios ask for interoperable software solutions to seamlessly integrate existing e-learning infrastructures and legacy tools with innovative technologies while being cognitively efficient to handle. In this way, prospective users are enabled to use them without learning overheads. At the same time, methods of Learning Design (LD) in combination with CBL are getting more and more important for production and maintenance of easy to facilitate solutions. We present our approach of developing a competence-based course-authoring and assignment support software. It is bridging the gaps between contemporary Learning Management Systems (LMS) and established legacy learning infrastructures by embedding existing resources via Learning Tools Interoperability (LTI). Furthermore, the underlying conceptual architecture for this integration approach will be explained. In addition, a competence management structure based on knowledge technologies supporting standardized skill and competence taxonomies will be introduced. The overall goal is to develop a software solution which will not only flawlessly merge into a legacy platform and several other learning environments, but also remain intuitively usable. As a proof of concept, the so-called platform independent conceptual architecture model will be validated by a concrete use case scenario.

El aprendizaje activo de la microbiología en el Grado de Podología incrementa el rendimiento académico

Se ha planteado como objetivo la mejora de la calidad de la docencia de la Microbiología mediante la actualización de la metodología docente , introduciendo como actividad docente el aprendizaje activo basado en preguntas (inquirybased learning:IBL) para conseguir mejorar las competencias que deberán adquirir los estudiantes como parte de su formación integral. En este estudio han participado 55 alumnos de Segundo Curso del Grado de Podología (Curso 2014-2015),y se ha calculado el porcentaje de alumnos que participaron en las 3 pruebas (3 IBL), en 2 (2 IBL), en 1 (1 IBL), y los que no participaron en ninguna y posteriormente se relacionó con las calificaciones obtenidas en la asignatura de Microbiología. Se incluyeron las preguntas IBL que se realizaron en clase en el campus virtual de la asignatura, pero sin incluir la corrección de las mismas. En los alumnos que realizaron alguna prueba IBL se obtuvieron calificaciones mejores en las preguntas diseñadas para analizar la síntesis de conocimientos y el análisis de datos que en aquellos que no habían participado en ninguna. Al finalizar la actividad se realizó un estudio transversal a través de un cuestionario autocumplimentado en el que se valoraba la opinión de los alumnos sobre el aprendizaje activo mediante IBL valorando positivamente esta actividad para medir el aprendizaje y mejorar la preparación del examen. Consideramos que el uso del campus virtual unido a la actualización en la metodología docente puede mejorar el rendimiento académico de los estudiantes de Microbiología.

BARRIERS AND SOLUTIONS TO OPEN SOURCE APPROPRIATE TECHNOLOGY FOR SUSTAINABLE DEVELOPMENT: INNOVATION THROUGH COLLABORATION

It has been proposed that the field of appropriate technology (AT) - small-scale, energy efficient and low-cost solutions, can be of tremendous assistance in many of the sustainable development challenges, such as food and water security, health, shelter, education and work opportunities. Unfortunately, there has not yet been a significant uptake of AT by organizations, researchers, policy makers or the mainstream public working in the many areas of the development sector. Some of the biggest barriers to higher AT engagement include: 1) AT perceived as inferior or ‘poor persons technology’, 2) questions of technological robustness, design, fit and transferability, 3) funding, 4) institutional support, as well as 5) general barriers associated with tackling rural poverty. With the rise of information and communication technologies (ICTs) for online networking and knowledge sharing, the possibilities to tap into the collaborative open-access and open-source AT are growing, and so is the prospect for collective poverty reducing strategies, enhancement of entrepreneurship, communications, education and a diffusion of life-changing technologies. In short, the same collaborative philosophy employed in the success of open source software can be applied to hardware design of technologies to improve sustainable development efforts worldwide. To analyze current barriers to open source appropriate technology (OSAT) and explore opportunities to overcome such obstacles, a series of interviews with researchers and organizations working in the field of AT were conducted. The results of the interviews confirmed the majority of literature identified barriers, but also revealed that the most pressing problem for organizations and researchers currently working in the field of AT is the need for much better communication and collaboration to share the knowledge and resources and work in partnership. In addition, interviews showcased general receptiveness to the principles of collaborative innovation and open source on the ground level. A much greater focus on networking, collaboration, demand-led innovation, community participation, and the inclusion of educational institutions through student involvement can be of significant help to build the necessary knowledge base, networks and the critical mass exposure for the growth of appropriate technology.

A Multicenter, Randomised Open Study of Early Corticosteroid Treatment (OSECT) in Preterm Infants With Respiratory Illness: Comparison of Early and Late Treatment and of Dexamethasone and Inhaled Budesonide

AIM: To compare early (15 days) steroid therapy and dexamethasone with inhaled budesonide in very preterm infants at risk of developing chronic lung disease. METHODS: Five hundred seventy infants from 47 neonatal intensive care units were enrolled. Criteria for enrollment included gestational age 30%. Infants were randomly allocated to 1 of 4 treatment groups in a factorial design: early (15 days) dexamethasone, and delayed selective budesonide. Dexamethasone was given in a tapering course beginning with 0.50 mg/kg/day in 2 divided doses for 3 days reducing by half until 12 days of therapy had elapsed. Budesonide was administered by metered dose inhaler and a spacing chamber in a dose of 400 microg/kg twice daily for 12 days. Delayed selective treatment was started if infants needed mechanical ventilation and >30% oxygen for >15 days. The factorial design allowed 2 major comparisons: early versus late treatment and systemic dexamethasone versus inhaled budesonide. The primary outcome was death or oxygen dependency at 36 weeks and analysis was on an intention-to-treat basis. Secondary outcome measures included death or major cerebral abnormality, duration of oxygen treatment, and complications of prematurity. Adverse effects were also monitored daily. RESULTS: There were no significant differences among the groups for the primary outcome. Early steroid treatment was associated with a lower primary outcome rate (odds ratio [OR]: 0.85; 95% confidence interval [CI]: 0.61,1.18) but even after adjustment for confounding variables the difference remained nonsignificant. Dexamethasone-treated infants also had a lower primary outcome rate (OR: 0.86; 95% CI: 0.62,1.20) but again this difference remained not significant after adjustment. For death before discharge, dexamethasone and early treatment had worse outcomes than budesonide and delayed selective treatment (OR: 1.42; 95% CI: 0.93,2.16; OR: 1.51; 95% CI: 0.99,2.30 after adjustment, respectively) with the results not quite reaching significance. Duration of supplementary oxygen was shorter in the early dexamethasone group (median: 31 days vs 40-44 days). Early dexamethasone was also associated with increased weight loss during the first 12 days of treatment (52 g vs 3 g) compared with early budesonide, but over 30 days there was no difference. In the early dexamethasone group, there was a reduced incidence of persistent ductus arteriosus (34% vs 52%-59%) and an increased risk of hyperglycemia (55% vs 29%-34%) compared with the other 3 groups. Dexamethasone was associated with an increased risk of hypertension and gastrointestinal problems compared with budesonide but only the former attained significance. CONCLUSIONS: Infants given early treatment and dexamethasone therapy had improved survival without chronic lung disease at 36 weeks compared with those given delayed selective treatment and inhaled budesonide, respectively, but results for survival to discharge were in the opposite direction; however, none of these findings attained statistical significance. Early dexamethasone treatment reduced the risk of persistent ductus arteriosus. Inhaled budesonide may be safer than dexamethasone, but there is no clear evidence that it is more or less effective

The VLT-FLAMES survey of massive stars: Observations in the Galactic clusters NGC 3293, NGC 4755 and NGC 6611

We introduce a new survey of massive stars in the Galaxy and the Magellanic Clouds using the Fibre Large Array Multi- Element Spectrograph ( FLAMES) instrument at the Very Large Telescope ( VLT). Here we present observations of 269 Galactic stars with the FLAMES- Giraffe Spectrograph ( R similar or equal to 25 000), in fields centered on the open clusters NGC3293, NGC4755 and NGC6611. These data are supplemented by a further 50 targets observed with the Fibre- Fed Extended Range Optical Spectrograph ( FEROS, R = 48 000). Following a description of our scientific motivations and target selection criteria, the data reduction methods are described; of critical importance the FLAMES reduction pipeline is found to yield spectra that are in excellent agreement with less automated methods. Spectral classifications and radial velocity measurements are presented for each star, with particular attention paid to morphological peculiarities and evidence of binarity. These observations represent a significant increase in the known spectral content of NGC3293 and NGC4755, and will serve as standards against which our subsequent FLAMES observations in the Magellanic Clouds will be compared.

Increasing Staff and Student Capacity to Use the Communication Facility in Queen's Online in Order to Support Learning and Teaching on a BSW Programme

In this article the authors explore and evaluate developments in the use of information and communications technologies (ICT) within social work education at Queen's University Belfast since the inception of the new degree in social work. They look at the staff development strategy utilised to increase teacher confidence and competence in use of the Queen's Online virtual learning environment tools as well as the student experience of participation in modules involving online discussions. The authors conclude that the project provided further opportunity to reflect on how ICT can be used as a platform to support a whole course in a systematic and coordinated way and to ensure all staff remained abreast of ongoing developments in the use of ICT to support learning which is a normative expectation of students entering universities. A very satisfying outcome for the leaders is our observation of the emergence of other 'experts' in different aspects of use of ICT amongst the staff team. This project also shows that taking a team as opposed to an individual approach can be particularly beneficial

The Open Method of Coordination on Health Care After the Lisbon Strategy II: Towards a Neoliberal Framing?

This paper undertakes a content analysis of the discourse on the Open Method of Coordination on Health Care (OMC/HC) in order to show how equity and solidarity are increasingly linked to optimisation and, as such, how neoliberalism increasingly frames health care. Some of the side-effects of this reframing for politics are highlighted: legitimating and extending EU governance, reducing the space for oppositional formations and limited citizenship. The analysis begins by interrogating the broader context of the Lisbon Strategy II, after which the techniques of the OMC/HC and its substantive outputs are analysed.

The immediate Life support course: implementation into an undergraduate nursing programme

This paper outlines how the immediate life support (ILS) course was incorporated into an undergraduate-nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The aim was to develop the student’s ability to recognise the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this the ILS course was only available to qualified nurses and this paper reports on the first time students were provided with an ILS course in an undergraduate setting. The ILS course was delivered to 89 third year nursing students (Adult Branch) and comprised one full teaching day per week over two weeks. Recognised Advanced Life Support (ALS) instructors, in keeping with the United Kingdom Resuscitation Council guidelines, taught the students. Participants completed a 17 item questionnaire which comprised an open-ended section for student comment. Questionnaire data was analysed descriptively using SSPSS version 15.0. Open-ended responses from the questionnaire data was analysed by content and thematic analysis. Results Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge Conclusion. The inclusion of the ILS course provides students with necessary skills to assess and manage the deteriorating patient. In addition the data from this study suggest the ILS course should be delivered in an inter-professional setting – i.e taught jointly with medical students. References: Department of Health & Quality Assurance Agency (2006). Department of Health Phase 2 benchmarking project – final report. Gloucester: Department of Health, London and Quality Assurance Agency for Higher Education