Typologies in GPs’ referral practice

Background: GPs’ individual decisions to refer and the various ways of working when they refer are important determinants of secondary care use. The objective of this study was to explore and describe potential characteristics of GPs’ referral practice by investigating their opinions about referring and their self-reported experiences of what they do when they refer. Methods: Observational cross-sectional study using data from 128 Norwegian GPs who filled in a questionnaire with statements on how they regarded the referral process, and who were invited to collect data when they actually referred to hospital during one month. Only elective referrals were recorded. The 57 participants (44,5 %) recorded data from 691 referrals. The variables were included in a principal component analysis. A multiple linear regression analysis was conducted to identify typologies with GP’s age, gender, specialty in family medicine and location as independent variables. Results: Eight principal components describe the different ways GPs think and work when they refer. Two typologies summarize these components: confidence characterizing specialists in family medicine, mainly female, who reported a more patient-centred practice making priority decisions when they refer, who confer easily with hospital consultants and who complete the referrals during the consultation; uncertainty characterizing young, mainly male non-specialists in family medicine, experiencing patients’ pressure to be referred, heavy workload, having reluctance to cooperate with the patient and reporting sparse contact with hospital colleagues. Conclusions: Training specialists in family medicine in patient-centred method, easy conference with hospital consultant and cooperation with patients while making the referral may foster both self-reflections on own competences and increased levels of confidence.publishedVersio

Getting the Facts Straight: NCCD Questions the "Impending Crime Wave" Report by Third Way

In February, 2008, the Third Way, which defines itself as a "nonprofit, nonpartisan strategy center for progressives," released a signifi cant policy statement entitled, The Impending Crime Wave. This paper describes the convergence of what the Third Way conceives of as four new and menacing sociological trends, which, together with recent federal disengagement from crime fighting, allegedly threaten a new and devastating wave of crime in America. The National Council on Crime and Delinquency (NCCD) reviewed the Third Way report and identified troubling flaws with its arguments and with the data used to support them. To begin with, NCCD found that the described "trends" are based on incorrect data, much of which was drawn from news stories or outdated data reports. In addition, the threatening tone of the report's title and language is a deliberate attempt to foster fear through the use of false statements. Also, the Third Way fails to indentify the precise age group they refer to throughout their arguments. This is an analysis of the Third Way report; it provides evidence from published studies and national data, and in some cases California data, and which highlights the inaccuracies of the Third Way's reasoning

Presenting a united front : assessed reflective writing on group experience

Assessed reflective writing is increasingly common in UK higher education. Students writing in this mode are typically required to narrate their experiences, evaluate their performance, investigate associated emotions, and comment on what has been learned. In this paper I focus on assessed reflective writing by students on an MA TESOL course who are required to write individual reflections on a process of working in a group to produce teaching materials. This task places particular demands on the writer. Like other students writing reflectively, they need to manage complex self presentation: to appear honest about relative successes and failures, to show evidence of appropriate reflection, and to indicate desirable learning. Because they are reflecting on a group experience, they also need to differentiate themselves from their work group in their account, and to reflect critically on others as well as on themselves. My focus in this paper is on the ways they manage these additional demands. I first examine the relative frequency with which writers refer to themselves and their work group, and then examine the content of self-referential and group-referential statements. Finally, I examine semantic patterns in the data and draw conclusions regarding possible reasons behind student writers’ choices about how to represent themselves and others

Coastal Zones of the Arid Tropics and Pastoral Systems: Focusing on Human-Camel Relationship

The purpose of this paper is to establish a general framework within which to consider pastoral systems in the coastal zones of the arid tropics, focusing on humancamel relationships. Points at issue were determined by reviewing literature related to three topics: 1) pastoral systems in the arid tropics; 2) pastoralists living in its coastal zones; 3) human-camel relationships. As a results of these analyses, I set up twelve topics for discussion: 1) What kinds of water do one-humped camels and camel pastoralists drink to live in the coastal zones of the arid tropics? 2) Which species of plants do one-humped camels graze there? 3) What are the differences in pasture utilization between one-humped camels and other livestock there? 4) Which species of biological resources in addition to plants do camel pastoralists utilize there? 5) How do the coastal physical environments determine biological resource utilization of camel pastoralists? 6) What kinds of niches do onehumped camels occupy in the coastal ecosystems in terms of resource patch accessibility and availability? 7) How do camel pastoralists refer to the physical environments and how do they classify them? 8) How do camel pastoralists refer to the biological environments and how do they classify them? 9) How do camel pastoralists refer to the one-humped camel and how do they classify them? 10) Which species of biological resources of the coastal zones of the arid tropics are traded, and to what extent are they traded? 11) What roles do one-humped camels play in the broader network building and inter-ethnic relationships? 12) How do the natural environments and pastoral systems of the coastal zones of the arid tropics affect the survival of ethnic groups? Finally, I summarize my discussion on some basic data from a case study of the Beja on the Red Sea coast in Eastern Sudan, and propose a direction for my study of pastoral systems in the arid tropics

Topic Similarity Networks: Visual Analytics for Large Document Sets

We investigate ways in which to improve the interpretability of LDA topic models by better analyzing and visualizing their outputs. We focus on examining what we refer to as topic similarity networks: graphs in which nodes represent latent topics in text collections and links represent similarity among topics. We describe efficient and effective approaches to both building and labeling such networks. Visualizations of topic models based on these networks are shown to be a powerful means of exploring, characterizing, and summarizing large collections of unstructured text documents. They help to "tease out" non-obvious connections among different sets of documents and provide insights into how topics form larger themes. We demonstrate the efficacy and practicality of these approaches through two case studies: 1) NSF grants for basic research spanning a 14 year period and 2) the entire English portion of Wikipedia.Comment: 9 pages; 2014 IEEE International Conference on Big Data (IEEE BigData 2014

Can MONDian vector theories explain the cosmic speed up ?

Generalized Einstein - Aether vector field models have been shown to provide, in the weak field regime, modifications to gravity which can be reconciled with the successfull MOND proposal. Very little is known, however, on the function F(K) defining the vector field Lagrangian so that an analysis of the viability of such theories at the cosmological scales has never been performed. As a first step along this route, we rely on the relation between F(K) and the MOND interpolating function $\mu(a/a_0)$ to assign the vector field Lagrangian thus obtaining what we refer to as "MONDian vector models". Since they are able by construction to recover the MOND successes on galaxy scales, we investigate whether they can also drive the observed accelerated expansion by fitting the models to the Type Ia Supernovae data. Should be this the case, we have a unified framework where both dark energy and dark matter can be seen as different manifestations of a single vector field. It turns out that both MONDian vector models are able to well fit the low redshift data on Type Ia Supernovae, while some tension could be present in the high z regime.Comment: 15 pages, 5 tables, 4 figures, accepted for publication on Physical Review

Four Essentials for Evaluation

GEO created this guide to help grantmakers get to the next level in their evaluation efforts. The target audience is champions and supporters of evaluation who want to embed these practices more deeply in the work of their organizations.The term "evaluation" can refer to a lot of different activities, including data collection, information gathering and research about grantmaker-supported activities. GEO's emphasis, however, is on "evaluation for learning."Evaluation is about more than ensuring that grantees are doing what they promise, or that a specific program area at a foundation is meeting its goals. Rather, it's about advancing knowledge and understanding among grantmakers, their grantees and their partners about what's working, what's not and how to improve their performance over time.Using evaluation in this way requires grantmakers to transform themselves into learning organizations. Beyond getting smarter about specific evaluation methods and approaches, this means adopting a continuous process, a culture and a commitment to support the capacity of people to see patterns and insights that can lead to ever-improving results

Benchmark on the Taxation Administrations in the EU: Competition for Capital Invested

In the year of 2007 Budapest Tech, Department of Enterprise Management in cooperation with Széchenyi István University, Department of Logistics and Forwarding started a project on the establishment of new transporting companies in Bulgaria and Romania. We focused on the differences between the countries newly joined the European Union on January 1, 2007 and Hungary. The latest enlargement of the EU was a good chance to examine the new countries what advantages and disadvantages they have. EU member countries are in free competition with each other because of the free flow of goods, capital, services and labour. Countries with different tax environment and policies open up new opportunities for companies. Data, tax rates, contributions and any fees mentioned in this working paper refer to the year of the project mentioned above.Bulgaria, Romania, tax environment, transportation, wages, contributions

Advice, guidance and “the overlooked middle” in English secondary education

Policymakers in Europe have devoted considerable resources and attention to low achievers in education, especially those who are or who are at risk of becoming NEET (not in education, employment or training) (Tomlinson 2013:102). At the other end of the spectrum British and American governments, amonst others, have also focused on high educational achievers who are considered to be ‘gifted’ (Balchin et al 2008). In contrast, Roberts (2012: 203) argues, “‘ordinariness’ tends to remain overlooked in contemporary research and policy discourses”. This paper addresses that neglect by specifically focusing on the group of ‘ordinary’ middle attainers in the context of English 14-19 education, who Hodgson and Spours (2013) have termed “the overlooked middle”. It draws on an analysis of statistical data from the government-funded Longitudinal Study of Young People in England (LSYPE) in order to quantify and identify this group of young people. In particular the data is analysed to investigate the relationship between the advice and guidance that these middle attainers receive and the post-16 qualifications that they select. Advice and guidance has a particularly important role in promoting social justice within the English context, where education and training are characterised by a plethora of highly differentiated courses for young people from 14 to 19. This diversity is the result of what Higham and Yeomans (2011: 217) refer to as “the hyperactivity of English policy and provision for 14- to 19-year-olds." The qualifications to which many of these courses lead are, however, of uncertain equivalence and uneven value, especially in vocational education and training (VET). Some of these qualifications have proved to be very short-lived. Data collection for the LSYPE covered a period (2004-2010) when new VET qualifications were being introduced in England with much publicity and when advice and guidance services were undergoing significant change. This paper uses the rich LSYPE dataset to address three research questions: • How many young people fall into the group of middle attainers and what, if anything, characterises them? • What formal advice and guidance does this group of young people receive? • What is the relationship between this advice and the post-16 qualifications they select