Assessing time knowledge in children aged 10 to 11 years

The acquisition of time knowledge involves learning how to read clocks, estimate time, read dates and learn about temporal sequences. Evidence suggests that many of these competencies are acquired by 10 years of age although not all children may follow this developmental path. The main purpose of this study was to collect normative data for a screening tool that assesses time knowledge. These data identify the prevalence and pattern of difficulties with time knowledge among a UK sample of Year 6 pupils (aged 10 to 11 years). The Time Screening Assessment tool (Doran, Dutt & Pembery, 2015), designed to assess time knowledge, was administered individually to a sample of 79 children. Findings revealed a median overall score of 32 out of a maximum score of 36. 25% of children performed at or close to ceiling, however seven children scored more than -1.5 standard deviations below the mean. The value of these findings to practitioners working with children in schools is discussed

Building Clinical Ethics Capacity, Final Report of the Developing Clinical Ethics Capacity in NSW Partnership project 2014

Clinical ethics support services are an established feature of health care in the US and Canada and are becoming so in the UK, France, Belgium and elsewhere in Europe. They are yet to be widely established in NSW or elsewhere Australia. Clinical ethics support typically involves the provision of expert ethics input into clinical education, policy development and the care of individual patients, particularly where this involves value, rather than clinical, or scientific, conflict. Ethics support is generally provided by an individual consultant, an ethics committee or some combination of the two. In its case consultation function, expert support is intended to clarify the values that are in tension and through promoting open and inclusive discussion, facilitate consensus on the appropriate next steps. Internationally, the guidance and recommendations issued by a support service on a particular case are, in most cases, advisory and not binding. Advocates argue that clinical ethics support is necessary because contemporary clinical work takes place in a technologically, socially and ethically complex environment. The medical encounter has become far more open to scrutiny and is accountable to a more diverse public holding often quite different interests, ideas and values. In a more pluralist society, professional training, professional codes and institutional polices aren’t sufficient to establish ethical practices and procedures or resolve the ethical dilemmas that arise in the care of individual patients. The ethics expertise provided by an ethicist or a panel of ethically trained clinicians is necessary to astutely appraise the values and arguments and generate consensus. Without such expertise the ethicality of practices cannot be assured. Clinical ethics support is intended to promote ethically sound clinical and organisational practices and decision-making and thereby contribute to health organisation and system quality improvement. The under-developed state of clinical ethics support in Australia and NSW prompted NSW Health, in partnership with the Centre of Values Ethics and Law in Medicine and the Centre for Health Law and Governance , to ask: 1. Do changes to the environment in which clinical practice occurs mean there is a need to change the way we deal with ethical dilemmas? 2. Is more formalised support for clinicians, when making difficult and possibly controversial ethical decisions, desirable or warranted? 3. If it is agreed that clinical ethics support should be enhanced, what model is most appropriate for local conditions?funding provided by the Centre for Epidemiology and Evidence, NSW Ministry of Healt

Clinical Ethics Support in Contemporary Health Care

This chapter concerns current initiatives to create and maintain specialized services to help respond to ethical issues that arise in the practice of health care. These initiatives, the obstacles they face, and the controversies they engender should be of considerable interest to those concerned with the management of health care organizations. This is because ethics is and should be intrinsic to routine health care practice. Also, no less, it is because ethical disputes and controversies, even if they seldom occur, can severely disrupt the complex organizations that deliver health care in modern societies. Clinical ethics support services (CES services) are comprised of an individual or group, usually in an organization, who can provide a suite of services to support all stakeholders in identifying and managing the ethical issues that inevitably arise in the design and delivery of health care. While there is a degree of consensus about the potential value of such services, they are also the focus of ongoing theoretical, methodological and political debates. This chapter does not aim to resolve these debates. Rather, our aim is to provide health care managers with an account of how and why CES services are becoming a part of the contemporary organizational landscape of health care, and describe the concerns that bioethicists and observers and critics of bioethics have raised regarding their role, function, and dissemination. We first describe the origins of CES services, to provide a context for the following discussion about the goals, functions and models of support that exist across this discipline—drawing on some relevant examples. We then describe how CES services can be evaluated. Third, we discuss initiatives that aim to optimise quality of CES services and some of the criticisms and suspicions that these initiatives have engendered. Finally, we offer some reflections on the direction that CES services may take in the future

Managing ethical issues in patient care and the need for clinical ethics support

Objective: To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia. Methods: Cross-sectional survey of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals. Results: Sixty-two (59%) respondents reported occasionally to often having ethical concerns. Forty-six (44%) reported often to occasionally having legal concerns. The three most common response to concerns was: talking to colleagues (96, 91.4%); raising the issue in a group forum (68, 65%) and consulting a relevant guideline. Most respondents were highly (62%) or moderately (31%) satisfied with the ethical environment of the hospital. Twenty-two (22%) were highly satisfied with the ethical environment of their department and 74 (75%) were moderately satisfied. A majority 72 (69%) of respondents indicated that additional support in dealing with ethical issues would be helpful. Conclusion: Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. While this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, the majority of respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia. Key Question Summary 1. What is known about the topic? Clinicians working in hospitals in the USA, Canada and the United Kingdom have access to ethics expertise to help them manage ethical issues that arise in patient care. How Australian clinicians currently manage the ethical issues they face has not been investigated 2. What does this paper add? This paper describes the types of ethical issues faced by Australian clinicians, how they manage these issues and whether they think ethics support would be helpful. 3. What are the implications for practitioners? Clinicians frequently encounter ethically and legally difficult decisions and want additional ethics support. Helping clinicians to provide ethically sound patient care should be a priority of public hospitals in NSW and elsewhere in Australia.NSW Ministry of Healt

Managing ethical issues in patient care and the need for clinical ethics support

Objective: To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia. Methods: Cross-sectional survey of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals. Results: Sixty-two (59%) respondents reported occasionally to often having ethical concerns. Forty-six (44%) reported often to occasionally having legal concerns. The three most common response to concerns was: talking to colleagues (96, 91.4%); raising the issue in a group forum (68, 65%) and consulting a relevant guideline. Most respondents were highly (62%) or moderately (31%) satisfied with the ethical environment of the hospital. Twenty-two (22%) were highly satisfied with the ethical environment of their department and 74 (75%) were moderately satisfied. A majority 72 (69%) of respondents indicated that additional support in dealing with ethical issues would be helpful. Conclusion: Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. While this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, the majority of respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia. Key Question Summary 1. What is known about the topic? Clinicians working in hospitals in the USA, Canada and the United Kingdom have access to ethics expertise to help them manage ethical issues that arise in patient care. How Australian clinicians currently manage the ethical issues they face has not been investigated 2. What does this paper add? This paper describes the types of ethical issues faced by Australian clinicians, how they manage these issues and whether they think ethics support would be helpful. 3. What are the implications for practitioners? Clinicians frequently encounter ethically and legally difficult decisions and want additional ethics support. Helping clinicians to provide ethically sound patient care should be a priority of public hospitals in NSW and elsewhere in Australia.NSW Ministry of Healt

Early Dark Energy Cosmologies

We propose a novel parameterization of the dark energy density. It is particularly well suited to describe a non-negligible contribution of dark energy at early times and contains only three parameters, which are all physically meaningful: the fractional dark energy density today, the equation of state today and the fractional dark energy density at early times. As we parameterize Omega_d(a) directly instead of the equation of state, we can give analytic expressions for the Hubble parameter, the conformal horizon today and at last scattering, the sound horizon at last scattering, the acoustic scale as well as the luminosity distance. For an equation of state today w_0 < -1, our model crosses the cosmological constant boundary. We perform numerical studies to constrain the parameters of our model by using Cosmic Microwave Background, Large Scale Structure and Supernovae Ia data. At 95% confidence, we find that the fractional dark energy density at early times Omega_early < 0.06. This bound tightens considerably to Omega_early < 0.04 when the latest Boomerang data is included. We find that both the gold sample of Riess et. al. and the SNLS data by Astier et. al. when combined with CMB and LSS data mildly prefer w_0 < -1, but are well compatible with a cosmological constant.Comment: 6 pages, 3 figures; references added, matches published versio

New Techniques for Analysing Axisymmetric Gravitational Systems. 1. Vacuum Fields

A new framework for analysing the gravitational fields in a stationary, axisymmetric configuration is introduced. The method is used to construct a complete set of field equations for the vacuum region outside a rotating source. These equations are under-determined. Restricting the Weyl tensor to type D produces a set of equations which can be solved, and a range of new techniques are introduced to simplify the problem. Imposing the further condition that the solution is asymptotically flat yields the Kerr solution uniquely. The implications of this result for the no-hair theorem are discussed. The techniques developed here have many other applications, which are described in the conclusions.Comment: 30 pages, no figure

Worldsheet Matter Superfields on Half-Shell

In this paper we discuss some of the effects of using "unidexterous" worldsheet superfields, which satisfy worldsheet differential constraints and so are partly on-shell, i.e., on half-shell. Most notably, this results in a stratification of the field space that reminds of "brane-world" geometries. Linear dependence on such superfields provides a worldsheet generalization of the super-Zeeman effect. In turn, non-linear dependence yields additional left-right asymmetric dynamical constraints on the propagating fields, again in a stratified fashion.Comment: 15 pages, 2 figures; minor algebraic correction

Cosmon dark matter?

We investigate if the fluctuations of the scalar field mediating quintessence -- the cosmon -- can play an important role in cosmology. Small fluctuations with short wavelength behave similar to a relativistic gas. In contrast, the contribution to the energy density from horizon size fluctuations may decrease less rapidly than radiation. We discuss the possibility that the cosmon fluctuations grow nonlinearly, form lumps and constitute the clustering dark matter of the universe. Cosmon dark matter would lead to interesting consequences for the equation of state and the coupling between quintessence and dark matter.Comment: Published version,correction in appendix A, 43 pages, LaTe

Acceleration and Classical Electromagnetic Radiation

Classical radiation from an accelerated charge is reviewed along with the reciprocal topic of accelerated observers detecting radiation from a static charge. This review commemerates Bahram Mashhoon's 60th birthday.Comment: To appear in Gen. Rel. Gra