A realistic evaluation of Early Warning Systems and acute care training in Northern Ireland: findings and recommendations

Statement of purpose The purpose of this concurrent session is to present the main findings and recommendations from a five year study evaluating the implementation of Early Warning Systems (EWS) and the Acute Life-threatening Events: Recognition and Treatment (ALERT) course in Northern Ireland. The presentation will provide delegates with an understanding of those factors that enable and constrain successful implementation of EWS and ALERT in practice in order to provide an impetus for change. Methods The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory [1]. The stages included identifying the programme theories underpinning EWS and ALERT, generating hypotheses, gathering empirical evidence and refining the programme theories. This approach used a variety of mixed methods including individual and focus group interviews, observation and documentary analysis of EWS compliance data and ALERT training records. A within and across case comparison facilitated the development of mid-range theories from the research evidence. Results The official RRS theories developed from the realist synthesis were critically evaluated and compared with the study findings to develop a mid-range theory to explain what works, for whom in what circumstances. The findings of what works suggests that clinical experience, established working relationships, flexible implementation of protocols, ongoing experiential learning, empowerment and pre-emptive management are key to the success of EWS and ALERT implementation. Each concept is presented as ‘context, mechanism and outcome configurations’ to provide an understanding of how the context impacts on individual reasoning or behaviour to produce certain outcomes. Conclusion These findings highlight the combination of factors that can improve the implementation and sustainability of EWS and ALERT and in light of this evidence several recommendations are made to provide policymakers with guidance and direction for future policy development. References: 1. Pawson R and Tilley N. (1997) Realistic Evaluation. Sage Publications; London Type of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast

The application of early contractor involvement and its impact on project performance

Early contractor involvement is a topic that has attracted attention from construction practitioners and researchers in the UK since the 1990s. It has been adopted to introduce construction knowledge and experience to the design process, and to integrate design with construction. In contrast with the limited number of previous studies on early contractor involvement, which used case studies, a questionnaire survey was conducted in this study, to investigate the application of early contractor involvement in current practice and its impact on project performance in terms of time, cost and quality. From an analysis of the questionnaire results, early contractor involvement is found to be increasingly used in the construction industry, and to have a significant impact on cost and time performance. This research provides empirical evidence related to the practice of early contractor involvement. It demonstrates the major influence of early contractor involvement on management processes and working relationships during a project, which contribute to performance improvement and project success.

Early Medieval farming and food production: a review of the archaeobotanical evidence from aarchaeological excavations in Ireland

Agriculture played an important role in the organisation of economy and society in early medieval Ireland (cal ad 400–1150). This paper examines archaeobotanical evidence for agricultural production and consumption, incorporating newly available data. Analysis of evidence from 60 sites revealed that hulled barley and oat were the dominant crops of this period. Naked wheat was present at many sites, but was not the primary crop in most cases. Rye was a minor crop in all locations where recorded. Other crops—including flax, pea and bean—were occasionally present. These crop choices provide a contrast with evidence from many other regions in contemporary Europe. In the case of Ireland, there is increased evidence for crops during the second half of the early medieval period, both in terms of the number of sites where remains were recovered and also the variety of crops cultivated; this may reflect a shift towards a greater emphasis on arable agriculture. The contribution of documentary sources and scientific analyses towards investigating food products is also highlighted in this study.

Formação de professores de ciências para o uso de tecnologias

Na atualidade, torna-se premente que os alunos exerçam um papel ativo face a problemáticas de cariz científico e tecnológico na sociedade em que se inserem. Neste contexto, tem sido recomendada a promoção da Educação em Ciências, com orientação Ciência-Tecnologia-Sociedade (CTS) para o desenvolvimento da Literacia científica dos alunos, em particular, do Ensino Básico (EB). As Tecnologias da Informação e Comunicação (TIC) têm-se assumido, cada vez mais, como recursos privilegiados para os alunos aprenderem ciências. Portanto, é fundamental que os professores de Ciências do EB considerem os aspetos pedagógico-didáticos relacionados com a integração das TIC no processo de ensino e aprendizagem (E/A) das Ciências. No entanto, vários estudos têm revelado que a maioria dos professores parece não integrar as TIC no processo de E/A, o que se relaciona, entre outros obstáculos, com a falta de formação a este nível. Por outro lado, em Portugal, são escassos os estudos relacionados com a formação de professores de Ciências do EB para o uso de TIC no processo de E/A, com orientação CTS. O presente estudo tem como finalidade a criação de uma proposta de esquema referencial para o desenvolvimento de programas de formação (PF) de professores de Ciências do EB com orientação CTS (inicial, contínua e pós-graduada), com vista ao desenvolvimento de “competências TIC” destes (futuros) profissionais. Para tal, procurou-se responder a duas questões de investigação: Que componentes curriculares privilegiar em PF de professores do EB, que contribuam para o desenvolvimento de competências de integração das tecnologias no processo de E/A, em geral, e das Ciências, em particular?; e Qual o contributo de um PF na promoção de práticas pedagógico-didáticas com orientação CTS de Professores de Ciências do EB? O estudo organizou-se em duas fases. A Fase I designou-se “Formação de Professores do Ensino Básico em Tecnologia Educativa”, decorreu entre janeiro de 2009 e novembro de 2009, e teve um caráter exploratório com vista a descrever estratégias para a promoção do desenvolvimento pessoal, social e profissional, em particular, na dimensão do Conhecimento Pedagógico Tecnológico de Conteúdo (CPTC), de estudantes/professores do EB (inicial, contínua e pós-graduada). O CPTC representa o conhecimento de professores do EB para integrar as TIC no processo de E/A das Ciências, de acordo com a Perspetiva de Ensino por Pesquisa (EPP). A recolha de dados envolveu: a análise documental de vinte e três unidades curriculares (UC) de Tecnologia Educativa (TE) de Cursos de Educação Básica (1.º Ciclo de Bolonha), de dezassete Instituições de Ensino Superior Público Português; e o inquérito por entrevista a quatro Investigadores Portugueses em TE. A análise de conteúdo do corpus recolhido possibilitou a identificação dos componentes curriculares a privilegiar em PF de professores do EB neste âmbito, tais como: i) a “competência digital” de “pesquisa, seleção e organização de informação”; ii) a “competência pedagógica com TIC” de “planificação e/ou implementação de atividades de E/A”; iii) a “competência pedagógica com TIC de nível avançado” de reflexão crítica; iv) o conteúdo curricular centrado na colaboração online; v) a estratégia/atividade de E/A de trabalho de projeto; vi) o cenário de E/A misto (b-learning); vii) as ferramentas da web 2.0 (ex. Blog); e viii) a avaliação formativa de portefólios digitais desenvolvidos pelos estudantes/professores do EB em formação. A Fase II denominou-se “Formação de Professores de Ciências do Ensino Básico com Orientação CTS”, decorreu entre dezembro de 2009 e maio de 2011, e teve um caráter interventivo, com o intuito de conceber, produzir, implementar e avaliar um PF com esta orientação. O PF foi integrado nas UC de “TIC e Educação em Ciências” (TIC_EC) e de “Didática das Ciências Integradas II” (DCI_II) do Mestrado em Didática, área de especialização das Ciências, da Universidade de Aveiro (no 2.º semestre do ano letivo 2009/2010). O Mestrando dirigiu-se a um público profissionalizado, em particular, Educadores de Infância, Professores do 1.º CEB e Professores de Matemática e Ciências Naturais do 2.º CEB. A avaliação do PF foi contínua durante todo o seu processo de desenvolvimento, o que implicou a recolha das perceções dos principais envolvidos (os dois Docentes de DCI_II e de TIC_EC, os nove Mestrandos, um especialista externo em TE e a Investigadora do estudo). Para tal recorreu-se ao inquérito por questionário e por entrevista, à observação participante da Investigadora e à análise dos portefólios digitais desenvolvidos pelos Mestrandos durante o PF. A avaliação final do PF ocorreu no final do mesmo e dez meses após a formação ter terminado (maio de 2011). A análise de conteúdo do corpus recolhido permitiu demonstrar que o PF foi exequível e eficaz no contexto em que se projetou, o que se comprova na evidência de práticas pedagógico-didáticas de utilização das TIC no processo de E/A das Ciências, com orientação CTS, por parte de Mestrandos envolvidos no PF. O esquema referencial resultante do estudo integra a “estratégia de investigação conduzida pelo professor”, pressupõe a sinergia entre as áreas científicas da Didática das Ciências (DC) e da TE, e implica a integração da dimensão do CPTC ao nível da formação de professores de Ciências do EB (inicial, contínua e pós-graduada). Neste âmbito, sugere-se o desenvolvimento de projetos CTS pelos (futuros) profissionais, com recurso às TIC, e tendo em conta a perspetiva de EPP. Considera-se que estudos desta natureza poderão ser um contributo para impulsionar a Educação em Ciências com orientação CTS recorrendo às potencialidades educativas das tecnologias, em particular no EB. Assim, preconiza-se a necessidade de se investir na transferência, expansão e avaliação do referencial a outros contextos de formação de professores de Ciências.

Developmental Antecedents of Proactive and Reactive Rebelliousness: The Role of Parenting Style, Childhood Adversity, and Attachment

Adolescence is a time of developmental transition that for one in five young people is characterised by feelings of oppositionality, rebellion, and negativism. Despite the prevalent experience of teen turbulence and despite its significance within the phenomenological framework provided by reversal theory (RT), the childhood antecedents of rebelliousness in adolescence and adulthood have not been given extensive empirical attention within RT, although such work has been carried out using other constructs and theories. We examined recalled parenting style, childhood adversity, and attachment style in adulthood as correlates of proactive and reactive rebelliousness in a sample of 80 participants, aged 18 to 50 years. Each participant responded to a questionnaire package containing the revised Adult Attachment Scale, the Parental Bonding Instrument, the Childhood Experience of Care and Abuse Questionnaire, and the Negativism Dominance Scale. We found that paternal abusive parenting, followed by paternal parenting style, paternal neglect, and paternal antipathy were independently predictive of scores on proactive rebelliousness, the sensation-seeking form. Maternal and paternal indifferent parenting styles each were found to equivalently and independently predict scores on reactive rebelliousness, the interpersonal disaffection form. The results of this study suggest these two forms of rebelliousness may have distinctly different antecedents. A longitudinal study is needed to examine the potentially causal pathways that are suggested by the results of this cross-sectional research. We consider reversal theory explanations of these results and contrast them with complementary theoretical frameworks.

Affective Instability, Childhood Trauma and Major Affective Disorders

BACKGROUND: Affective instability (AI), childhood trauma, and mental illness are linked, but evidence in affective disorders is limited, despite both AI and childhood trauma being associated with poorer outcomes. Aims were to compare AI levels in bipolar disorder I (BPI) and II (BPII), and major depressive disorder recurrent (MDDR), and to examine the association of AI and childhood trauma within each diagnostic group. METHODS: AI, measured using the Affective Lability Scale (ALS), was compared between people with DSM-IV BPI (n=923), BPII (n=363) and MDDR (n=207) accounting for confounders and current mood. Regression modelling was used to examine the association between AI and childhood traumas in each diagnostic group. RESULTS: ALS scores in descending order were BPII, BPI, MDDR, and differences between groups were significant (p<0.05). Within the BPI group any childhood abuse (p=0.021), childhood physical abuse (p=0.003) and the death of a close friend in childhood (p=0.002) were significantly associated with higher ALS score but no association was found between childhood trauma and AI in BPII and MDDR. LIMITATIONS: The ALS is a self-report scale and is subject to retrospective recall bias. CONCLUSIONS: AI is an important dimension in bipolar disorder independent of current mood state. There is a strong link between childhood traumatic events and AI levels in BPI and this may be one way in which exposure and disorder are linked. Clinical interventions targeting AI in people who have suffered significant childhood trauma could potentially change the clinical course of bipolar disorder.

Curriculum and beyond: Mathematics support for first year life science students

The move into higher education is a real challenge for students from all educational backgrounds, with the adaptation to a new curriculum and style of learning and teaching posing a daunting task. A series of exercises were planned to boost the impact of the mathematics support for level four students and was focussed around a core module for all students. The intention was to develop greater confidence in tackling mathematical problems in all levels of ability and to provide more structured transition period in the first semester of level 4. Over a two-year period the teaching team for Biochemistry and Molecular Biology provided a series of structured formative tutorials and “interactive” online problems. Video solutions to all formative problems were made available, in order that students were able to engage with the problems at any time and were not disadvantaged if they could not attend. The formative problems were specifically set to dovetail into a practical report in which the mathematical skills developed were specifically assessed. Students overwhelmingly agreed that the structured formative activities had broadened their understanding of the subject and that more such activities would help. Furthermore, it is interesting to note that the package of changes undertaken resulted in a significant increase in the overall module mark over the two years of development.

Master's in autonomous systems: an overview of the robotics curriculum and outcomes at ISEP, Portugal

Robotics research in Portugal is increasing every year, but few students embrace it as one of their first choices for study. Until recently, job offers for engineers were plentiful, and those looking for a degree in science and technology would avoid areas considered to be demanding, like robotics. At the undergraduate level, robotics programs are still competing for a place in the classical engineering graduate curricula. Innovative and dynamic Master’s programs may offer the solution to this gap. The Master’s degree in autonomous systems at the Instituto Superior de Engenharia do Porto (ISEP), Porto, Portugal, was designed to provide a solid training in robotics and has been showing interesting results, mainly due to differences in course structure and the context in which students are welcomed to study and work

Master's in Autonomous Systems: An Overview of the Robotics Curriculum and Outcomes at ISEP, Portugal

Robotics research in Portugal is increasing every year, but few students embrace it as one of their first choices for study. Until recently, job offers for engineers were plentiful, and those looking for a degree in science and technology would avoid areas considered to be demanding, like robotics. At the undergraduate level, robotics programs are still competing for a place in the classical engineering graduate curricula. Innovative and dynamic Master's programs may offer the solution to this gap. The Master's degree in autonomous systems at the Instituto Superior de Engenharia do Porto (ISEP), Porto, Portugal, was designed to provide a solid training in robotics and has been showing interesting results, mainly due to differences in course structure and the context in which students are welcomed to study and work.

Daily physical activities and sports in adult survivors of childhood cancer and healthy controls: a population-based questionnaire survey.

BACKGROUND: Healthy lifestyle including sufficient physical activity may mitigate or prevent adverse long-term effects of childhood cancer. We described daily physical activities and sports in childhood cancer survivors and controls, and assessed determinants of both activity patterns. METHODOLOGY/PRINCIPAL FINDINGS: The Swiss Childhood Cancer Survivor Study is a questionnaire survey including all children diagnosed with cancer 1976-2003 at age 0-15 years, registered in the Swiss Childhood Cancer Registry, who survived ≥5 years and reached adulthood (≥20 years). Controls came from the population-based Swiss Health Survey. We compared the two populations and determined risk factors for both outcomes in separate multivariable logistic regression models. The sample included 1058 survivors and 5593 controls (response rates 78% and 66%). Sufficient daily physical activities were reported by 52% (n = 521) of survivors and 37% (n = 2069) of controls (p<0.001). In contrast, 62% (n = 640) of survivors and 65% (n = 3635) of controls reported engaging in sports (p = 0.067). Risk factors for insufficient daily activities in both populations were: older age (OR for ≥35 years: 1.5, 95CI 1.2-2.0), female gender (OR 1.6, 95CI 1.3-1.9), French/Italian Speaking (OR 1.4, 95CI 1.1-1.7), and higher education (OR for university education: 2.0, 95CI 1.5-2.6). Risk factors for no sports were: being a survivor (OR 1.3, 95CI 1.1-1.6), older age (OR for ≥35 years: 1.4, 95CI 1.1-1.8), migration background (OR 1.5, 95CI 1.3-1.8), French/Italian speaking (OR 1.4, 95CI 1.2-1.7), lower education (OR for compulsory schooling only: 1.6, 95CI 1.2-2.2), being married (OR 1.7, 95CI 1.5-2.0), having children (OR 1.3, 95CI 1.4-1.9), obesity (OR 2.4, 95CI 1.7-3.3), and smoking (OR 1.7, 95CI 1.5-2.1). Type of diagnosis was only associated with sports. CONCLUSIONS/SIGNIFICANCE: Physical activity levels in survivors were lower than recommended, but comparable to controls and mainly determined by socio-demographic and cultural factors. Strategies to improve physical activity levels could be similar as for the general population.

Factor structure of early smoking experiences and associations with smoking behavior: valence or sensitivity model?

The Early Smoking Experience (ESE) questionnaire is the most widely used questionnaire to assess initial subjective experiences of cigarette smoking. However, its factor structure is not clearly defined and can be perceived from two main standpoints: valence, or positive and negative experiences, and sensitivity to nicotine. This article explores the ESE's factor structure and determines which standpoint was more relevant. It compares two groups of young Swiss men (German- and French-speaking). We examined baseline data on 3,368 tobacco users from a representative sample in the ongoing Cohort Study on Substance Use Risk Factors (C-SURF). ESE, continued tobacco use, weekly smoking and nicotine dependence were assessed. Exploratory structural equation modeling (ESEM) and structural equation modeling (SEM) were performed. ESEM clearly distinguished positive experiences from negative experiences, but negative experiences were divided in experiences related to dizziness and experiences related to irritations. SEM underlined the reinforcing effects of positive experiences, but also of experiences related to dizziness on nicotine dependence and weekly smoking. The best ESE structure for predictive accuracy of experiences on smoking behavior was a compromise between the valence and sensitivity standpoints, which showed clinical relevance.