Value for money in schools: Report for the Audit Office

In January 2008, the Audit Commission appointed FGS, in association with the University of Southampton, to carry out a review in relation to Value for Money (VfM) in schools. Examining VfM in schools requires a detailed consideration of both the inputs and the outputs relating to the education system; in other words, the costs and benefits associated with schools. In this context, inputs are relatively straightforward to express: staffing typically represents around 70% of school costs, with the remainder comprising of operating and maintenance expenditure. However, defining the outputs from schools (pupil outcomes) is an altogether more complex task. The most tangible measure of pupil outcomes is the results they achieve in examinations. Even so, both in the UK and overseas, it is widely recognised that pupils’ levels of achievement are influenced by a range of factors other than the quality of schooling they receive (for example, their family background or their track record of achievement at earlier stages of their education). Put simply, pupils’ current levels of attainment are likely to be enhanced if they have a high level of prior educational attainment, and therefore schools may make a less significant contribution to student outcomes. In assessing the value for money which schools deliver through their day-to-day activities, it is therefore necessary to take account of the progress pupils make in their time at school (or ‘value added’ by the school), rather than just their levels of attainment, which are influenced by a host of factors other than schooling. <br/

Wilms' tumour outcomes at Red Cross Children's Hospital 1979-2003

Includes bibliographical references (leaves 78-96).BACKGROUND: In Africa Wilms' tumour frequently presents with advanced disease. This study reports our results over 25 years using the National Wilms' Tumor Study Group approach of primary surgery, in the form of nephrectomy, followed by chemotherapy. A small number of these tumours are bilateral and here surgery has evolved from simple nephrectomy into the use of nephron-sparing techniques. METHODS: A retrospective analysis was performed on all patients diagnosed with Wilms' tumour between January 1979 and December 2003. Treatment was according to National Wilms' Tumor Study Group protocols. For unilateral Wilms' tumour primary surgery, where possible, was followed by adjuvant chemotherapy with vincristine and dactinomycin. Doxorubicin was added for stage III and IV tumours. Other drugs were used for unfavourable histology, and radiotherapy was reserved for local stage III tumours and pulmonary metastases. Patients with bilateral Wilms' tumours underwent initial bilateral biopsy, neoadjuvant chemotherapy and tumourectomy. Where indicated, nephrectomy (partial or complete) involved using ice dam topical cooling and vascular control, and in one case bench surgery and extensive renal reconstruction with orthotopic autotransplantation. Revision tumourectomy was utilized on three occasions for recurrence in areas of nephroblastomatosis. Radiotherapy was reserved for pulmonary metastases and palliation. RESULTS: There were 188 children with unilateral Wilms' tumour and 20 with bilateral Wilms' tumour. Among those with unilateral Wilms' tumour fifty seven (30.3%) were stage I, 33 (17.6%) were stage II, 60 (31.9%) were stage III and 38 (20.2%) were stage IV. Twenty-four patients (12.8%) had unfavourable histology. Fifteen of the bilateral Wilms' tumours had a synchronous presentation, one with liver metastases at diagnosis, and five were metachronous. Nephroblastomatosis was identified in 18 of the 20 patients (90%) with bilateral Wilms' tumour. One hundred and forty five patients are alive and disease free, 23 to 318 months from diagnosis. The estimated 5-year overall survival for all unilateral Wilms' tumours was 78.3%; 82.8% for favourable histology and 47.3% for unfavourable histology. Among those with favourable histology, estimated 5-year overall survival was 94.6% for stage I, 96.2% for stage II, 78.4% for stage III and 54.2% for stage IV. There was no difference in overall survival between those favourable histology stage III tumours that were operable and those deemed inoperable. Intra-operative spillage was uncommon (8%), and did not increase local relapse rate. Survival of stage IV disease has not improved over the last decade. mong those with bilateral Wilms' tumours, 11 are alive free of disease one to fifteen years after completing treatment, all with well-preserved renal function. Nine have died (two of unrelated disease), including six of the seven with spread outside the kidney. All three with unfavourable histology are alive, as are four of the five with a metachronous presentation. Survival for bilateral Wilms' tumour has improved markedly in the last decade. CONCLUSIONS AND RECOMMENDATIONS" National Wilms' Tumor Study Group protocols employed in a South African setting with highly competent and experienced surgical care, produced results for non-metastatic favourable histology unilateral Wilms' tumour comparable to those of the National Wilms' Tumor Study Group. For bilateral Wilms' tumours appropriate chemotherapy together with conservative (nephron-sparing) and innovative surgery produced good results with preservation of adequate renal function in nearly all cases. We can seek to improve outcomes via better risk stratification with molecular markers, new adjuvant chemotherapy regimes for high risk tumours and novel surgical approaches to improve nephron-sparing in bilateral Wilms' tumour. Improving results in Stage IV patients may depend as much on earlier diagnosis, as on advances in therapeutics

Enhancing Social Support through Adventure Education: The Case of Fathers and Sons

Adventure education (AE) research often utilizes social support as an outcome variable associated with participation in extended outdoor adventure trips. Social support is defined as “the degree to which individuals have access to social resources, in the form of relationships, on which they can rely” (Johnson & Sarason, 1979). Using an adventure-based program offering a treatment specifically designed for father and son participants, significant changes in pre-post comparison scores on the variables of trust, communication, and social support were reported for both fathers and sons. Qualitative analysis revealed four major themes: communication enhancement, instructor influence, course components, and shared time. Based on these results, AE programming can be effective in increasing social support between fathers and sons, enabling them both to learn valuable life lessons about father-son interactions and communication benefits

How photonic networking can help data centres

In light of rapidly increasing demand for ultra-high speed data transmission, data centres are under pressure to provide ever increasing data transmission through their networks and at the same time improve the quality of data handling in terms of reduced latency, increased scalability and improved channel speed for users. However as data rates increase, present electronic switching technology using current data centre architecture is becoming increasingly difficult to scale despite improved data management. In this paper electronic scalability issues will be discussed and alternative optical solutions will be reviewed including a novel and highly scalable optical interconnect

Has silicon reached its limit?

In light of the rapidly increasing demand for ultra-high speed data transmission, data centres are under pressure to provide ever increasing data transmission through their networks and at the same time improve the quality of data handling in terms of reduced latency, increased scalability and improved channel speed for users. However as data rates increase, present electronic switching technology using current data centre architecture is becoming increasingly difficult to scale despite improvements in data management. In this paper the tremendous bandwidth potential of optical fibre based networks will be explored alongside the issues of electronic scalability and switching speed. A resulting need for alternative optical solutions for all-optical signal processing systems will be discussed. With this in mind, progress in the form of a novel and highly scalable optical interconnect will be reviewed

Toward novel wearable pyroelectric temperature sensor for medical applications

Knowledge of an amputees’ residual limb skin temperature is considered to be of particular importance as an indicator of tissue health. Temperature within the prosthetic socket typically varies over the range 25°C to 35°C and this warm, confined environment causes sweating which creates favourable conditions for both the growth of bacteria and an increased risk of tissue breakdown. With this in mind a wearable sensor for the real-time measurement of temperature variations at the prosthetic socket/liner interface is under development and a proof of concept prototype is presented. The sensor exploits the large pyroelectric effect present in ferroelectric lead zirconate titanate (PbZr)x (Ti)(1-x)(O3) (PZT) and has several inherent advantages over other methods of temperature sensing. The sensing element is a low cost commercially available thick-film PZT device. Mathematical models are developed to describe the sensor immitance and response to temperature change, and both the clamped and unclamped capacitances are investigated over the range 20°C to 40°C. Sensor characteristics were found to be dominated by the clamped dielectric constant and operation under short-circuit conditions is found to offer a constant sensor gain over the temperature range of interes

Effects of a single interprofessional simulation session on medical and nursing students’ attitudes toward interprofessional learning and professional identity: a questionnaire study

Background Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK. Method Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured. Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures. Results A total of 194 medical and 266 nursing students completed questionnaires. A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site. Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students. Conclusions Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace. Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect