A Phenomenographic Study to Investigate what we Mean by the Term “Professional Skills” – Preliminary Findings

Recent calls for reform of engineering education have highlighted the importance of treating the engineering education system holistically; not only looking at developing curriculum components nor proposing new teaching pedagogies to enhance graduate skills. One aspect of this holistic view, which has not been given due cognisance is the impact that academic conceptions can have on the experience of the student in the educational system. The authors propose that academics teaching on engineering programmes do not share a common understanding of what we mean by “professional skills”, nor assume the same teaching and learning processes which develop these skills. It is unlikely that large scale reform of engineering education will be successful until we better understand and therefore allow for variations in conceptions of what we term here, “Professional Skills”. This paper reports on preliminary findings of a PhD study; a phenomenographic study of academic conceptions of the term professional skills in engineering graduates in Ireland. These preliminary results show that there are at least four qualitatively different ways in which the academics interviewed, conceive of the term professional skills. It is hoped that the results will enable academics to better understand how their own conceptions are similar to, or how they differ from their colleagues and so can enable them to better see how their own strategies can help reform engineering education. This paper presents preliminary findings and hopes to generate discussion at the conference to help define, debate and shape the findings of the overall stud

Improvement of Information Retrieval Systems

Recent advances in modular archetypes and knowledge-based archetypes are never at odds with extreme programming. In this paper, authors disconfirm the development of active networks, demonstrates the typical importance of machine learning. We use collaborative archetypes to demonstrate that operating systems can be made constant-time, linear-time, and relational

When groups help and when groups harm: origins, developments, and future directions of the 'social cure' perspective of group dynamics

A substantial literature supports the important role that social group memberships play in enhancing health. While the processes through which group memberships constitute a ‘Social Cure’ are becoming increasingly well-defined, the mechanisms through which these groups contribute to vulnerability and act as a ‘Social Curse’ are less understood. We present an overview of the Social Cure literature, and then go beyond this to show how the processes underpinning the health benefits of group membership can also negatively affect individuals through their absence. First, we provide an overview of early Social Cure research. We then describe later research concerning the potential health benefits of identifying with multiple groups, before moving on to consider the ‘darker side’ of the Social Cure by exploring how intra-group dynamics can foster Curse processes. Finally, we synthesise evidence from both the Cure and Curse literatures to highlight the complex interplay between these phenomena, and how they are influenced by both intra- and inter-group processes. We conclude by considering areas we deem vital for future investigation within the discipline

Public Health England: Social prescribing approaches for migrants: call for evidence

This submission is built on Social Prescribing (SP) and Migration research conducted through a co-production design (two roundtables). The aim of the coproduction roundtables was to identify barriers and facilitators of health service access and satisfaction among migrants, and recommendations for using SP with migrant populations. The submission focuses on four key topics which are discussed in detail within the main body of this submission below: -A holistic approach to the health needs of migrant populations -Barriers to health service access, satisfaction with healthcare and implications for SP -Unique challenges for SP delivery -Strategies to improve service access and migrant satisfaction with service

Comparative effectiveness of sodium-glucose cotransporter 2 inhibitors vs sulfonylureas in patients with type 2 diabetes

IMPORTANCE: In the treatment of type 2 diabetes, evidence of the comparative effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors vs sulfonylureas-the second most widely used antihyperglycemic class after metformin-is lacking. OBJECTIVE: To evaluate the comparative effectiveness of SGLT2 inhibitors and sulfonylureas associated with the risk of all-cause mortality among patients with type 2 diabetes using metformin. DESIGN, SETTING, AND PARTICIPANTS: A cohort study used data from the US Department of Veterans Affairs compared the use of SGLT2 inhibitors vs sulfonylureas in individuals receiving metformin for treatment of type 2 diabetes. A total of 23 870 individuals with new use of SGLT2 inhibitors and 104 423 individuals with new use of sulfonylureas were enrolled between October 1, 2016, and February 29, 2020, and followed up until January 31, 2021. EXPOSURES: New use of SGLT2 inhibitors or sulfonylureas. MAIN OUTCOMES AND MEASURES: This study examined the outcome of all-cause mortality. Predefined variables and covariates identified by a high-dimensional variable selection algorithm were used to build propensity scores. The overlap weighting method based on the propensity scores was used to estimate the intention-to-treat effect sizes of SGLT2 inhibitor compared with sulfonylurea therapy. The inverse probability of the treatment adherence weighting method was used to estimate the per-protocol effect sizes. RESULTS: Among the 128 293 participants (mean [SD] age, 64.60 [9.84] years; 122 096 [95.17%] men), 23 870 received an SGLT2 inhibitor and 104 423 received a sulfonylurea. Compared with sulfonylureas, SGLT2 inhibitors were associated with reduced risk of all-cause mortality (hazard ratio [HR], 0.81; 95% CI, 0.75-0.87), yielding an event rate difference of -5.15 (95% CI, -7.16 to -3.02) deaths per 1000 person-years. Compared with sulfonylureas, SGLT2 inhibitors were associated with a reduced risk of death, regardless of cardiovascular disease status, in several categories of estimated glomerular filtration rate (including rates from \u3e90 to ≤30 mL/min/1.73 m2) and in participants with no albuminuria (albumin to creatinine ratio [ACR] ≤30 mg/g), microalbuminuria (ACR \u3e30 to ≤300 mg/g), and macroalbuminuria (ACR \u3e300 mg/g). In per-protocol analyses, continued use of SGLT2 inhibitors was associated with a reduced risk of death compared with continued use of sulfonylureas (HR, 0.66; 95% CI, 0.60-0.74; event rate difference, -10.10; 95% CI, -12.97 to -7.24 deaths per 1000 person-years). In additional per-protocol analyses, continued use of SGLT2 inhibitors with metformin was associated with a reduced risk of death compared with SGLT2 inhibitor treatment without metformin (HR, 0.70; 95% CI, 0.50-0.97; event rate difference, -7.62; 95% CI, -17.12 to -0.48 deaths per 1000 person-years). CONCLUSIONS AND RELEVANCE: In this comparative effectiveness study analyzing data from the US Department of Veterans Affairs, among patients with type 2 diabetes receiving metformin therapy, SGLT2 inhibitor treatment was associated with a reduced risk of all-cause mortality compared with sulfonylureas. The results provide data from a real-world setting that might help guide the choice of antihyperglycemic therapy

Clinical implications of estimated glomerular filtration rate dip following sodium-glucose cotransporter-2 inhibitor initiation on cardiovascular and kidney outcomes

Background The frequency of the initial short-term decline in estimated glomerular filtration rate (eGFR), eGFR dip, following initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and its clinical implications in real-world practice are not clear. Methods and Results We built a cohort of 36 638 new users of SGLT2i and 209 025 new users of other antihyperglycemics. Inverse probability weighting was used to estimate the excess rate of eGFR dip, risk of the composite cardiovascular outcome of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, or all-cause mortality, and risk of the composite kidney outcome of eGFR decline \u3e50%, end-stage kidney disease, or all-cause mortality. In the first 6 months of therapy, compared with other antihyperglycemics, excess rates of eGFR dip \u3e10% and eGFR dip \u3e30% were 9.86 (95% CI: 8.83-11.00) and 1.15 (0.70-1.62) per 100 SGLT2i users, respectively. In mediation analyses that accounted for eGFR dipping, SGLT2i use was associated with reduced risk of cardiovascular and kidney outcomes (hazard ratio, 0.92 [0.84-0.99] and 0.78 [0.71-0.87], respectively); the magnitude of the association reduced by eGFR dipping was small for both outcomes. SGLT2i was associated with reduced risk of both outcomes in those with higher than average probability of eGFR dip \u3e10% or 30%. Compared with discontinuation, continued use of SGLT2i at 6 months was associated with reduced risk of cardiovascular and kidney outcomes in those with no eGFR dip or eGFR dip ≤10%, in those with eGFR dip \u3e10%, and in those with eGFR dip \u3e30%. Conclusions The salutary association of SGLT2i with cardiovascular and kidney outcomes was maintained regardless of eGFR dipping; concerns about eGFR dipping should not preclude use, and occurrence of eGFR dip after SGLT2i initiation may not warrant discontinuation

Evaluation and exploration of a social prescribing initiative: study protocol

Attention is being given to healthcare initiatives with the potential to save money and improve lives. One example is Social Prescribing (SP), which supports patients whose ill-health is exacerbated by loneliness. While evidence has accumulated attesting to SP’s efficacy, one limitation has been the lack of a theoretical framework, which limits understanding of how tackling loneliness improves health. In our evaluation of an SP pathway, we adopt a 'Social Cure' approach, which posits that social relations affect health. Our study will evaluate the efficacy of the pathway and determine the extent to which group processes are responsible for health improvements

Feasibility and acceptability of an oral pathology asynchronous tele-mentoring intervention: A protocol

Introduction: Oral cancer remains prevalent, despite being largely preventable. The widespread use of technology at chairside, combined with advances in electronic health record (EHR) capabilities, present opportunities to improve oral cancer screening by dentists, especially for disadvantaged patients with severe health needs. Design and methods: Using a mixed-methods approach, we will evaluate the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions using the following 3 methods: 1) administering provider surveys that consist of a checklist of 10 key components of the intervention based on process, and asking the dental provider subjects if each one was covered; 2) conducting semi-structured interviews informed by the Consolidated Framework for Implementation Research and the Implementation Outcomes Framework with dental resident subjects to assess specific barriers to sustaining the intervention and strategies for addressing these barriers to facilitate integration of the intervention into the routine workflow of the dental clinics; and 3) administering brief exit interviews with patient subjects regarding the acceptability of the intervention to assess satisfaction with the use of intra-oral cameras at chairside to screen for and refer patients with oral lesions and identification of these oral lesions via EHR and secure e-mail tele-mentoring with an oral pathology expert.Expected impact of the study for public health: If successful, then later clinical trials will maximize the external validity of the intervention and facilitate the widespread implementation and dissemination of the model for the teaching of dentists and residents, with the ultimate goal of improving patient care