Fear in childbirth: are the media responsible?

This is the second year that the Centre for Midwifery, Maternal and Perinatal Health convened a debate as part of the Festival of Learning at Bournemouth University (BU). The debate encourages members of the public and service users to get involved in our research and education and ensures that what we do at BU is relevant and current. Last year the team debated the pros and cons of allowing women free choice with regard to major medical interventions, such as caesarean section (Hundley et al. 2013). This year the focus was on the role of the media in childbirth. Social perceptions and beliefs about childbirth can increase women’s requests for interventions, such as caesarean section, with long-term health implications for mothers and babies. The debate was planned to explore the role of the mass media in shaping these beliefs and identify whether media portrayals are responsible for rising rates of intervention. Attendees were given the opportunity to voice their views and to vote for or against the motion. The motion for debate was: This house believes that: The media is responsible for creating fear in childbirth

Developing Scenarios for Product Longevity and Sufficiency

This paper explores the narrative of peoples’ relationships with products as a window on understanding the types of innovation that may inform a culture of sufficiency. The work forms part of the 'Business as Unusual: Designing Products with Consumers in the Loop' [BaU] project, funded as part of the UK EPSRC-ESRC RECODE network (RECODE, 2016) that aims to explore the potential of re-distributed manufacturing (RdM) in a context of sustainability. This element of the project employed interviews, mapping and workshops as methods to investigate the relationship between people and products across the product lifecycle. A focus on product longevity and specifically the people-product interactions is captured in conversations around product maintenance and repair. In exploring ideas of ‘broken’ we found different characteristics of, and motivations for, repair. Mapping these and other product-people interactions across the product lifecycle indicated where current activity is, who owns such activity (i.e. organisation or individual) and where gaps in interactions occur. These issues were explored further in a workshop which grouped participants to look at products from the perspective of one of four scenarios; each scenario represented either short or long product lifespans and different types of people engagement in the design process. The findings help give shape to new scenarios for designing sufficiency-based social models of material flows

A landscape of repair

This paper reports on EPSRC-funded research that explores the role of repair in creating new models of sustainable business. In the lifecycle stage of repair we explore what 'broken' means and uncover the nature of local and dispersed repair activities. This in turn allows us to better understand how the relationship between products and people can help shape new modes of consumption. Therefore, narratives of repair are collected to identify diverse people-product interactions and illustrate the different characteristics of, and motivations for, repair. The paper proposes that mapping the different product-people interactions across the product lifecycle, particularly at the stage of fragile-functionality (performance or function failure, emotional disengagement, superseded technology) is important in understanding the potential for enduring products and their repair. Building a landscape of repair creates new opportunities for manufacture and for slowing resource loops across product lifetimes, which together provide a framework for a sufficiency-based model of production and consumption

Analyses of high-level radioactive glasses and sludges at the Savannah River Site

Reliable analyses of high level radioactive glass and sludge are necessary for successful operation of the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). This facility will convert the radioactive waste sludges at SRS into durable borosilicate glasses for final disposal in a geologic repository. Analyses that are crucial to DWPF operation and repository acceptance of the glass are measurement of the radioactive and nonradioactive composition of the waste sludges and final glasses and measurement of the Fe(II)/Fe(III) ratio in a vitrified sample of melter feed. These measurements are based on the remote dissolutions of the glass and sludge followed by appropriate chemical analyses. Glasses are dissolved by a peroxide fusion method and a method using HF, HNO{sub 3}, H{sub 3}BO{sub 3}, and HCl acids where the solutions are heated in a microwave oven. The resulting solutions are analyzed by inductively coupled plasma-atomic emission spectroscopy (ICP-AES) and atomic absorption spectroscopy (AAS) for nonradioactive elements and appropriate counting techniques for radioactive elements. Results for two radioactive glasses containing actual radioactive waste are also presented. Sludges are dissolved by the Na{sub 2}O{sub 2} fusion method and an aqua regia method. 8 refs., 4 tabs

The academic backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

Background: Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods: Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results: Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies. Conclusions: The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital’ and 'medical capital’). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection

Construct-level predictive validity of educational attainment and intellectual aptitude tests in medical student selection: meta-regression of six UK longitudinal studies

Background: Measures used for medical student selection should predict future performance during training. A problem for any selection study is that predictor-outcome correlations are known only in those who have been selected, whereas selectors need to know how measures would predict in the entire pool of applicants. That problem of interpretation can be solved by calculating construct-level predictive validity, an estimate of true predictor-outcome correlation across the range of applicant abilities. Methods: Construct-level predictive validities were calculated in six cohort studies of medical student selection and training (student entry, 1972 to 2009) for a range of predictors, including A-levels, General Certificates of Secondary Education (GCSEs)/O-levels, and aptitude tests (AH5 and UK Clinical Aptitude Test (UKCAT)). Outcomes included undergraduate basic medical science and finals assessments, as well as postgraduate measures of Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) performance and entry in the Specialist Register. Construct-level predictive validity was calculated with the method of Hunter, Schmidt and Le (2006), adapted to correct for right-censorship of examination results due to grade inflation. Results: Meta-regression analyzed 57 separate predictor-outcome correlations (POCs) and construct-level predictive validities (CLPVs). Mean CLPVs are substantially higher (.450) than mean POCs (.171). Mean CLPVs for first-year examinations, were high for A-levels (.809; CI: .501 to .935), and lower for GCSEs/O-levels (.332; CI: .024 to .583) and UKCAT (mean = .245; CI: .207 to .276). A-levels had higher CLPVs for all undergraduate and postgraduate assessments than did GCSEs/O-levels and intellectual aptitude tests. CLPVs of educational attainment measures decline somewhat during training, but continue to predict postgraduate performance. Intellectual aptitude tests have lower CLPVs than A-levels or GCSEs/O-levels. Conclusions: Educational attainment has strong CLPVs for undergraduate and postgraduate performance, accounting for perhaps 65% of true variance in first year performance. Such CLPVs justify the use of educational attainment measure in selection, but also raise a key theoretical question concerning the remaining 35% of variance (and measurement error, range restriction and right-censorship have been taken into account). Just as in astrophysics, ‘dark matter’ and ‘dark energy’ are posited to balance various theoretical equations, so medical student selection must also have its ‘dark variance’, whose nature is not yet properly characterized, but explains a third of the variation in performance during training. Some variance probably relates to factors which are unpredictable at selection, such as illness or other life events, but some is probably also associated with factors such as personality, motivation or study skills

Considering embodied energy and carbon in heritage buildings – a review

Approximately 20% of UK buildings can be defined as ‘heritage buildings’, offering unique values that should be preserved. They tend to use more energy than newer buildings, creating a strong case for energy retrofits to reduce energy use, greenhouse gas emissions, and improve thermal comfort. However, few studies of heritage retrofits examine embodied impacts, which are the energy and carbon impacts required to manufacture, transport and construct materials and components. This study considers the whole life (embodied plus operational) impacts of retrofitting heritage buildings, through a systematic literature review and thematic analysis. It concludes that; both embodied and operational impacts should be considered in retrofitting projects, retrofitting is better than demolish and rebuild in lifecycle terms, there is a lack of policy mandating for the measurement of lifecycle impacts and low impact retrofitting can be better for conserving heritage values and reducing embodied carbon

MASP-1 Induces a Unique Cytokine Pattern in Endothelial Cells: A Novel Link between Complement System and Neutrophil Granulocytes

Microbial infection urges prompt intervention by the immune system. The complement cascade and neutrophil granulocytes are the predominant contributors to this immediate anti-microbial action. We have previously shown that mannan-binding lectin-associated serine protease-1 (MASP-1), the most abundant enzyme of the complement lectin pathway, can induce p38-MAPK activation, NFkappaB signaling, and Ca(2+)-mobilization in endothelial cells. Since neutrophil chemotaxis and transmigration depends on endothelial cell activation, we aimed to explore whether recombinant MASP-1 (rMASP-1) is able to induce cytokine production and subsequent neutrophil chemotaxis in human umbilical vein endothelial cells (HUVEC). We found that HUVECs activated by rMASP-1 secreted IL-6 and IL-8, but not IL-1alpha, IL-1ra, TNFalpha and MCP-1. rMASP-1 induced dose-dependent IL-6 and IL-8 production with different kinetics. rMASP-1 triggered IL-6 and IL-8 production was regulated predominantly by the p38-MAPK pathway. Moreover, the supernatant of rMASP-1-stimulated HUVECs activated the chemotaxis of neutrophil granulocytes as an integrated effect of cytokine production. Our results implicate that besides initializing the complement lectin pathway, MASP-1 may activate neutrophils indirectly, via the endothelial cells, which link these effective antimicrobial host defense mechanisms

Are wildcard events on infrastructure systems opportunities for transformational change?

Infrastructure systems face a number of pressing challenges relating to demographics, environment, finance and governance pressures. Furthermore, infrastructure mediates the way in which everyday lives are conducted; their form and function creating a persistence of unsustainable practice and behaviour that cannot be changed even if change is desired. There is a need to find means by which this obduracy can be broken so that new, more sustainable futures can be planned. This paper develops a methodology, taking concepts from both engineering and social science. Wild cards, or physical disruptions, are used to ‘destructively test’ complex infrastructure systems and the multi-level perspective is used as a framework for analysing the resulting data. This methodology was used to examine a number of case studies, and with focus groups consisting of a range of different infrastructure providers and managers, to gain a better understanding of systems’ sociotechnical characteristics and behaviours. A number of impactful ‘intervention points’ emerged that offered the opportunity to promote radical changes towards configurations of infrastructure systems that provide for ‘less’ physical infrastructure. This paper also examines the utility of wild cards as enablers of transition to these ‘less’ configurations and demonstrates how a ‘wild card scenario’ can be used to co-design infrastructure adaptation from with both infrastructure providers and users