Up In The Air: How Airlines Can Improve Performance by Engaging Their Employees

[Excerpt] In the chapters that follow, we explore the competitive strategies and employment-relations strategies found in the United States (chapter 2) and in a range of other countries (chapter 3), before and after deregulation. In chapter 4 we analyze recent trends in quality, productivity, and costs, as well as employee outcomes. In chapter 5 we look more closely at selected new-entrant airlines and find a wide range of competitive and employment-relations strategies being used in this segment of the industry. In chapter 6, we examine several legacy airlines and identify the distinct strategies they have adopted to respond to competitive pressures from new-entrant airlines. These chapters each focus on selected U.S. airlines and those based in some other countries. In chapter 7, we summarize the strategies of new-entrant and legacy airlines, and offer lessons about how airlines can and do change their strategies over time in their efforts to compete more effectively. We offer recommendations, using our historical and comparative analyses to discuss whether a path forward can be identified that can provide a better balance in stakeholder outcomes. We end on a positive note, arguing that if the parties learn from their experiences and from each other, in the United States and other countries, there is a path that deals with the pressures building up in the airline industry, offering hope for a better balance between investor, employee, customer, and societal interests. Key questions are whether and from where the leadership will come to get the industry moving down this path or whether the main parties might not take such action before there is a perfect storm

A proteomic approach to determining cause of death in sudden unexpected death in infancy (SUDI)

Introduction: Despite improvements in the understanding of infant death over recent years, many infants die each year in whom no cause of death is identified. There is evidence to suggest that a proportion of these unexplained deaths are the consequence of infection, either by a classical mechanism or as a consequence of the action of bacterial toxins. Post mortem tests for bacteria are robust, but there is a lack of effective post mortem tests for inflammatory markers which might assist in the interpretation of bacteriological results, and for identification of bacterial toxins. Methods: Proteomic techniques including biomarker discovery techniques using liquid chromatography mass spectrometry, and targeted techniques using multiple reaction monitoring tandem mass spectrometry, were used to identify potential biomarkers for infection and identify bacterial organisms and toxins, with a view to creating clinically-useful tests. Results: First, a rapid test for three biomarkers was developed which allows identification of infection and sepsis with high sensitivity and specificity in post mortem liver samples; this may be rapidly translated for clinical use. Second, a highly specific and sensitive test for Staphylococcus aureus and seven Staphylococcal exotoxins was developed which may be used to study the significance of Staphylococcal toxins in infant deaths. Furthermore this technique may adapted to identify other organisms; allowing potential use as a rapid diagnostic test in clinical practice in the living. Thirdly, the tests developed have identified inflammatory markers which are decreased in infants dying of infection; raising the possibility that acquired immune paresis may contribute to these deaths. This finding contributes to the understanding of mechanisms of fatal infection in infants, and in their prevention and management. Finally, a number of mitochondrial proteins have found to be raised in SIDS cases, which may provide additional insight into the mechanism of death in some of these cases

An assessment of forward and inverse GIA solutions for Antarctica

In this work we assess the most recent estimates of glacial isostatic adjustment (GIA) for Antarctica, including those from both forward and inverse methods. The assessment is based on a comparison of the estimated uplift rates with a set of elastic-corrected GPS vertical velocities. These have been observed from an extensive GPS network and computed using data over the period 2009-2014. We find systematic underestimations of the observed uplift rates in both inverse and forward methods over specific regions of Antarctica characterized by low mantle viscosities and thin lithosphere, such as the northern Antarctic Peninsula and the Amundsen Sea Embayment, where its recent ice discharge history is likely to be playing a role in current GIA. Uplift estimates for regions where many GIA models have traditionally placed their uplift maxima, such as the margins of Filchner-Ronne and Ross ice shelves, are found to be overestimated. GIA estimates show large variability over the interior of East Antarc tica which results in increased uncertainties on the ice-sheet mass balance derived from gravimetry methods

Decreasing cloud cover drives the recent mass loss on the Greenland Ice Sheet

peer reviewedThe Greenland Ice Sheet (GrIS) has been losing mass at an accelerating rate since the mid-1990s. This has been due to both increased ice discharge into the ocean and melting at the surface, with the latter being the dominant contribution. This change in state has been attributed to rising temperatures and a decrease in surface albedo. We show, using satellite data and climate model output, that the abrupt reduction in surface mass balance since about 1995 can be attributed largely to a coincident trend of decreasing summer cloud cover enhancing the melt-albedo feedback. Satellite observations show that, from 1995 to 2009, summer cloud cover decreased by 0.9 ± 0.3% per year. Model output indicates that the GrIS summer melt increases by 27 ± 13 gigatons (Gt) per percent reduction in summer cloud cover, principally because of the impact of increased shortwave radiation over the low albedo ablation zone. The observed reduction in cloud cover is strongly correlated with a state shift in the North Atlantic Oscillation promoting anticyclonic conditions in summer and suggests that the enhanced surface mass loss from the GrIS is driven by synoptic-scale changes in Arctic-wide atmospheric circulation

Pilot study of a social network intervention for heroin users in opiate substitution treatment: study protocol for a randomized controlled trial

Background: Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. The National Treatment Agency for Substance Misuse recommends the involvement of families and wider social networks in supporting drug users' psychological treatment, and this pilot randomized controlled trial aims to evaluate the impact of a social network-focused intervention for patients receiving OST.Methods and design: In this two-site, early phase, randomized controlled trial, a total of 120 patients receiving OST will be recruited and randomized to receive one of three treatments: 1) Brief Social Behavior and Network Therapy (B-SBNT), 2) Personal Goal Setting (PGS) or 3) treatment as usual. Randomization will take place following baseline assessment. Participants allocated to receive B-SBNT or PGS will continue to receive the same treatment that is routinely provided by drug treatment services, plus four additional sessions of either intervention. Outcomes will be assessed at baseline, 3 and 12 months. The primary outcome will be assessment of illicit heroin use, measured by both urinary analysis and self-report. Secondary outcomes involve assessment of dependence, psychological symptoms, social satisfaction, motivation to change, quality of life and therapeutic engagement. Family members (n = 120) of patients involved in the trial will also be assessed to measure the level of symptoms, coping and the impact of the addiction problem on the family member at baseline, 3 and 12 months.Discussion: This study will provide experimental data regarding the feasibility and efficacy of implementing a social network intervention within routine drug treatment services in the UK National Health Service. The study will explore the impact of the intervention on both patients receiving drug treatment and their family members.Trial registration: Trial Registration Number: ISRCTN22608399. ISRCTN22608399 registration: 27/04/2012. Date of first randomisation: 14/08/2012. © 2013 Day et al.; licensee BioMed Central Ltd

Surgical-PEARL protocol:a multicentre prospective cohort study exploring aetiology, management and outcomes for patients with congenital anomalies potentially requiring surgical intervention

INTRODUCTION: Congenital anomalies affect over 2% of pregnancies. Surgical advances have reduced mortality and improved survival for patients with congenital anomalies potentially requiring surgical (CAPRS) intervention. However, our understanding of aetiology, diagnostic methods, optimal management, outcomes and prognostication is limited. Existing birth cohorts have low numbers of individual heterogenous CAPRS. The Surgical Paediatric congEnital Anomalies Registry with Long term follow-up (Surgical-PEARL) study aims to establish a multicentre prospective fetal, child and biological parent cohort of CAPRS. METHODS AND ANALYSIS: From 2022 to 2027, Surgical-PEARL aims to recruit 2500 patients with CAPRS alongside their biological mothers and fathers from up to 15 UK centres. Recruitment will be antenatal or postnatal dependent on diagnosis timing and presentation to a recruitment site. Routine clinical data including antenatal scans and records, neonatal intensive care unit (NICU) records, diagnostic and surgical data and hospital episode statistics will be collected. A detailed biobank of samples will include: parents’ blood and urine samples; amniotic fluid if available; children’s blood and urine samples on admission to NICU, perioperatively or if the child has care withdrawn or is transferred for extracorporeal membrane oxygenation; stool samples; and surplus surgical tissue. Parents will complete questionnaires including sociodemographic and health data. Follow-up outcome and questionnaire data will be collected for 5 years. Once established we will explore the potential of comparing findings in Surgical-PEARL to general population cohorts born in the same years and centres. ETHICS AND DISSEMINATION: Ethical and health research authority approvals have been granted (IRAS Project ID: 302251; REC reference number 22/SS/0004). Surgical-PEARL is adopted onto the National Institute for Health Research Clinical Research Network portfolio. Findings will be disseminated widely through peer-reviewed publication, conference presentations and through patient organisations and newsletters. TRIAL REGISTRATION NUMBER: ISRCTN12557586

Revising on the run or studying on the sofa: prospective associations between physical activity, sedentary behaviour, and exam results in British adolescents.

BACKGROUND: We investigated prospective associations between physical activity/sedentary behaviour (PA/SED) and General Certificate of Secondary Education (GCSE) results in British adolescents. METHODS: Exposures were objective PA/SED and self-reported sedentary behaviours (screen (TV, Internet, Computer Games)/non-screen (homework, reading)) measured in 845 adolescents (14·5y ± 0·5y; 43·6 % male). GCSE results at 16y were obtained from national records. Associations between exposures and academic performance (total exam points) were assessed using multilevel mixed-effects linear regression adjusted for mood, BMI z-score, deprivation, sex, season and school; potential interactions were investigated. RESULTS: PA was not associated with academic performance. One-hour more accelerometer-assessed SED was associated with (β(95 % CI)) 6·9(1·5,12·4) more GCSE points. An extra hour of screen time was associated with 9.3(-14·3,-4·3) fewer points whereas an extra hour of non-screen time (reading/homework) was associated with 23·1(14·6,31·6) more points. Screen time was still associated with poorer scores after adjusting for objective PA/SED and reading/homework. CONCLUSIONS: An extra hour/day of screen time at 14·5y is approximately equivalent to two fewer GCSE grades (e.g., from B to D) at 16y. Strategies to achieve the right balance between screen and non-screen time may be important for improving academic performance. Concerns that encouraging more physical activity may result in decreased academic performance seem unfounded.The work of Kirsten Corder, Andrew J Atkin, and Esther M F van Sluijs was supported, wholly or in part, by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence (RES-590-28-0002). Funding from the British Heart Foundation, Department of Health, Economic and Social Research Council, Medical Research Council, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The work of Kirsten Corder, Esther M F van Sluijs, Ulf Ekelund and Soren Brage was supported by the Medical Research Council (MC_UP_1001/2, MC_U106179473, MC_UU_12015/3). The ROOTS data collection was supported by a programme grant to Ian Goodyer 074296/Z/04/Z from the Wellcome Trust and by the Medical Research Council Epidemiology Unit. The funders had no role in preparation of this manuscript. We thank Rebekah Steele and Charlotte Ridgway for assistance during data collection, and Kate Westgate and Stefanie Mayle from the physical activity technical team, and Paul Collings from the Physical Activity Programme, at the MRC Epidemiology Unit for their assistance in processing Actiheart data.This is the final version of the article. It first appeared from BioMed Central via http://dx.doi.org/10.1186/s12966-015-0269-

Prospective associations between sedentary time, sleep duration and adiposity in adolescents.

OBJECTIVE: The objective of this study was to investigate whether objectively measured sedentary time and sleep duration are associated with changes in adiposity from mid- to late adolescence. METHODS: Students (n = 504, 42% boys) were recruited from schools in Cambridgeshire, UK. At baseline (mean age 15.0 ± 0.3 years), sedentary time was objectively measured by ≥3 days of combined heart rate and movement sensing. Concurrently, sleep duration was measured by combined sensing in conjunction with self-reported bed times. Fat mass index (FMI; kg/m(2)) was estimated at baseline and follow-up (17.5 ± 0.3 years) by anthropometry and bioelectrical impedance. FMI change (ΔFMI) was calculated by subtracting the baseline from follow-up values. Linear regression models adjusted for basic demographics, moderate-to-vigorous physical activity (MVPA), and depressive symptoms were used to investigate associations of sedentary time and sleep duration (mutually adjusted for one another) with ΔFMI. RESULTS: FMI increased by 0.5 and 0.6 kg/m(2) in boys and girls, respectively, but there was no association between sedentary time and ΔFMI in either gender (p ≥ 0.087), and no association between sleep duration and ΔFMI in girls (p ≥ 0.61). In boys, each additional hour of baseline sleep significantly reduced the ΔFMI by 0.13 kg/m(2) (p = 0.049), but there was little evidence for this association after adjusting for MVPA and depressive symptoms (p = 0.15). CONCLUSIONS: Sedentary time may not determine changes in adiposity from mid- to late adolescence, nor may sleep duration in girls. However, sleep length may be inversely associated with adiposity gain in boys, depending on whether the relationship is confounded or mediated by MVPA and depression.This work was supported by the Medical Research Council (Unit Programme number MC_UU_12015/3), the Wellcome Trust (grant 074296/Z/04/Z) and the British Heart Foundation (grant FS/12/58/29709 to KW).This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.sleep.2015.02.53

An evaluation into procalcitonin levels in full-term neonates managed for suspected early onset sepsis due to probable maternal intrapartum sepsis

Purpose: To investigate procalcitonin (PCT) levels in full-term neonates managed for suspected early onset sepsis (EOS) due to probable maternal intrapartum sepsis. Methods: Prospective longitudinal observational study at University Hospitals of Bristol NHS Foundation trust. Included were a total of 117 neonates managed for suspected EOS from June to October 2020. In addition to routine full-blood-counts and c-reactive protein (CRP) tests, serum PCT levels were also measured as part of the septic screen and follow-up blood tests. Placentas were sent for histopathology analysis. Neonatal parameters were used to categorize cases into: “high-suspicion bacterial sepsis (BS),” “equivocal BS” and “low-suspicion BS.” Statistical test Kruskal-Wallis compared categories with biomarker values and placental histopathology scores. Results: A higher percentage of PCT levels showed elevation in comparison to CRP levels in the initial testing (55.3% versus 5.9%) and follow-up testing (98.9% versus 35%). There was a significant difference between the “low-suspicion BS” and “high-suspicion BS” categories for both the initial and follow-up PCT results. 71.2% of placentas showed varying degrees of chorioamnionitis. Conclusion: This study provides evidence to the physiological rise in PCT during the first few days of life. The significant difference in PCT levels according to clinical severity shows that PCT could be utilized in calculating odds for EOS, but as a standalone test will have limited use

Short-term variability in Greenland Ice Sheet motion forced by time-varying meltwater inputs: implications for the relationship between subglacial drainage system behavior and ice velocity.

High resolution measurements of ice motion along a -120 km transect in a land-terminating section of the GrIS reveal short-term velocity variations (<1 day), which are forced by rapid variations in meltwater input to the subglacial drainage system from the ice sheet surface. The seasonal changes in ice velocity at low elevations (<1000 m) are dominated by events lasting from 1 day to 1 week, although daily cycles are largely absent at higher elevations, reflecting different patterns of meltwater input. Using a simple model of subglacial conduit behavior we show that the seasonal record of ice velocity can be understood in terms of a time-varying water input to a channelized subglacial drainage system. Our investigation substantiates arguments that variability in the duration and rate, rather than absolute volume, of meltwater delivery to the subglacial drainage system are important controls on seasonal patterns of subglacial water pressure, and therefore ice velocity. We suggest that interpretations of hydro-dynamic behavior in land-terminating sections of the GrIS margin which rely on steady state drainage theories are unsuitable for making predictions about the effect of increased summer ablation on future rates of ice motion. © 2012. American Geophysical Union