Cotton spinning to climbing gear: practical aspects of design evolution in Lancashire and the North West of England

This article looks at the role of path dependency in the design of outdoor clothing and equipment, from the perspective of changing and overlapping industrial clusters in Lancashire and Sheffield, from the 1960s. It demonstrates that, unlike the fashion market, design in mountaineering clothing and equipment was originally based heavily upon functionality and hence on user innovation. It shows that skills and knowledge which evolved during the industrial revolution, in both industrial areas, were vitally important to the development of internationally competitive mountaineering equipment firms. It was, however, the way in which these sources of knowledge were combined with sporting expertise that contributed to the design of innovative functional products. In addition, fundamental changes occurred in the relationship between manufacturers and their customers and these were vital to the success of this process, marking a departure from past practice

Emergency and on-demand health care: modelling a large complex system

This paper describes how system dynamics was used as a central part of a whole-system review of emergency and on-demand health care in Nottingham, England. Based on interviews with 30 key individuals across health and social care, a 'conceptual map' of the system was developed, showing potential patient pathways through the system. This was used to construct a stock-flow model, populated with current activity data, in order to simulate patient flows and to identify system bottle-necks. Without intervention, assuming current trends continue, Nottingham hospitals are unlikely to reach elective admission targets or achieve the government target of 82% bed occupancy. Admissions from general practice had the greatest influence on occupancy rates. Preventing a small number of emergency admissions in elderly patients showed a substantial effect, reducing bed occupancy by 1% per annum over 5 years. Modelling indicated a range of undesirable outcomes associated with continued growth in demand for emergency care, but also considerable potential to intervene to alleviate these problems, in particular by increasing the care options available in the community

Quality of care for NSAID users: development of an assessment tool

Objective. Assessments of NSAID use based on authoritative guidelines typically overlook patients’ views and nuances of \ud medical history. Our objective was to develop an assessment tool that incorporates these aspects, and technical items, for quality of care assessments in NSAID users. \ud \ud Methods. Patients newly referred to a university hospital were interviewed by a nurse using an agreed template. A multidisciplinary group of rheumatologists, nurse specialists, primary care physicians and a pharmacist reviewed current guidance and systematic reviews on NSAID use, and a series of interview transcripts. The group agreed, by informal consensus, important determinants of effective and safe NSAID use. Technical aspects of medical care and items that reflected interpersonal care were included in an index for assessing quality of care for individual patients. Interview transcripts of 100 patients were scored by panel members and reliability of scores was tested by calculating weighted percentage agreement and the kappa statistic. \ud \ud Results. Our final index had five domains: medical risk factors; steps taken to reduce risk; knowledge of adverse effects; NSAID dose; and cost efficiency. Each item was scored 0, 1 or 2. Scores were summed, giving a maximum of 10 (low scores indicating low quality). Intra-rater agreement was >90%; kappa was 0.47–0.87 for individual domains and 0.59 for overall score. Inter-rater agreement for overall score was 95%; kappa was 0.25–0.78 for domains and 0.48 for overall score. Patients with especially low scores were identified using the mode of scores for five assessors; obvious clinical concerns were identified, supporting index face validity. \ud \ud Conclusions. A simple index to evaluate quality of care for NSAID users based on a patient interview is described. This may be used by one or more assessors to examine care standards and highlight deficiencies in relation to NSAID use in practice

The Season Ticket, April 1992

Columbia Theater/Music Center newsletter. 6 pages. Departmental news, production, faculty, student, and theater news.https://digitalcommons.colum.edu/seasonticket/1007/thumbnail.jp

Taking a Stance on Doping. Online Press Evaluation of a Parliamentary Select Committee’s Investigations into Doping in British Cycling

Between 2016 and 2017, the Parliamentary Select Digital, Culture, Media and Sport Committee was charged by the House of Commons to investigate doping in British sport, following revelations in the press that this practice was widespread. This study focuses on the witness sessions involving exponents of cycling, a sport frequently linked with performance enhancement. The study adopts a Computer-Assisted Discourse Studies (CADS) approach. By comparing a corpus of the Committee hearings with a corpus of online media coverage, the study offers a detailed qualitative analysis of stance and evaluation strategies in both corpora. Analysis highlights the importance of stance adverbials for witnesses and Committee members alike. It also reveals patterns of attitude adverbials. It is shown how patterns of stance in the hearing prime the press account of the issue, resulting in predominantly negative evaluations that reduce the complexity of the issue to an oversimplified more polarized account, presumably in the interests of newsworthiness

Why history? Why now? Multiple accounts of the emergence of academic development

More than 40 years after its beginnings, academic development stands uncertainly on the threshold of becoming a profession or discipline in its own right. While it remains marginal to the dominant stories of the university, it has become central to the institution's contemporary business. This Research Note describes an enquiry that uses a multiple histories approach to explore the emergence of academic development in three national sites. Our intention is to provoke a more critical engagement with academic development's current forms and future possibilities

Socialism, internationalism and Zionism: the independent Labour Party and Palestine, c.1917–1939

Using the Independent Labour Party (ILP) as its case study, this thesis examines the relationship between the labour movement’s interpretations of internationalism and its attitudes towards Zionism during the interwar years. The study locates responses to developments in Palestine within the broader framework of the labour movement’s conceptualisation of internationalist thought and practice with regard to issues such as immigration, imperialism and nationalism. Moreover, it examines the phenomenon of left-wing anti-Zionism, which has often been inadequately explored in the existing historiography of the interwar period. The ILP contained within it a broad spectrum of opinion; its intra-sectional debates therefore frequently reflected the diversity of thought within the labour movement. Furthermore, an analysis of the ILP’s debates requires a consideration of transnational perspectives because of the party’s involvement in networks and organisations such as the League Against Imperialism (LAI). Because of the party’s manifold links to variety of actors on political scene, it can serve as a prism through which we can explore the breadth of political debates within the left, both within Britain and at an international level. The thesis is divided into five thematic chapters, starting with a broad discussion of internationalist thought within in the ILP. The second chapter examines internal ILP debates on Palestine, while the third analyses how international left-wing organisations – notably the Labour and Socialist International (LSI) and the LAI – approached the issue. This is followed by an analysis of how ILPers interpreted the role of League of Nations Mandates, with particular focus on Palestine. Finally, the question of anti-Semitism and its influence on the ILP’s stance regarding mandatory rule and Zionism is considered. This study draws extensively on records relating to the Labour Party, the ILP, the LSI and the LAI, using sources such as conference reports, pamphlets, and newspapers. In addition, the personal papers and correspondence of key figures such as Ramsay MacDonald and James Maxton have been consulted

Does the process map influence the outcome of quality improvement work? A comparison of a sequential flow diagram and a hierarchical task analysis diagram

Background: Many quality and safety improvement methods in healthcare rely on a complete and accurate map of the process. Process mapping in healthcare is often achieved using a sequential flow diagram, but there is little guidance available in the literature about the most effective type of process map to use. Moreover there is evidence that the organisation of information in an external representation affects reasoning and decision making. This exploratory study examined whether the type of process map - sequential or hierarchical - affects healthcare practitioners' judgments.Methods: A sequential and a hierarchical process map of a community-based anti coagulation clinic were produced based on data obtained from interviews, talk-throughs, attendance at a training session and examination of protocols and policies. Clinic practitioners were asked to specify the parts of the process that they judged to contain quality and safety concerns. The process maps were then shown to them in counter-balanced order and they were asked to circle on the diagrams the parts of the process where they had the greatest quality and safety concerns. A structured interview was then conducted, in which they were asked about various aspects of the diagrams.Results: Quality and safety concerns cited by practitioners differed depending on whether they were or were not looking at a process map, and whether they were looking at a sequential diagram or a hierarchical diagram. More concerns were identified using the hierarchical diagram compared with the sequential diagram and more concerns were identified in relation to clinical work than administrative work. Participants' preference for the sequential or hierarchical diagram depended on the context in which they would be using it. The difficulties of determining the boundaries for the analysis and the granularity required were highlighted.Conclusions: The results indicated that the layout of a process map does influence perceptions of quality and safety problems in a process. In quality improvement work it is important to carefully consider the type of process map to be used and to consider using more than one map to ensure that different aspects of the process are captured