A prospective audit examining non-attendance at a surgical outpatients clinic in Mater Dei Hospital, Malta, and methods to reduce this problem

Non-attendance at hospital outpatient clinics is a longstanding issue that has potentially serious clinical implications, and contributes a significant financial burden to health care services. The aims of this study were to identify the rate of non-attendance at a surgical outpatients clinic in Mater Dei Hospital, Malta, ascertain the reasons for non-attendance, and to identify patients’ opinions on the implementation of a text-messaging reminder system as a means of reducing the non- attendance rate. Four outpatient clinics were observed over one month and the total number of appointments documented. Non-attenders were contacted via telephone call and asked to explain their non-attendance and whether a text-messaging reminder system may have increased their likelihood of attendance. Of the 266 appointments (217 females, 49 males, mean age 56 + 16 years), 80 patients failed to turn up, representing a 30% non-attendance rate. The main reasons for non-attendance were forgetfulness (53%), and unawareness of the appointment (26%). 90% of non-attenders stated that a text-messaging reminder might have prevented them missing their appointment, with 97% suggesting that such as system would be an acceptable method of trying to reduce this problem. Thus application of a text- messaging reminder system represents a potential solution for reducing the high rate of missed outpatient appointments, which is both cost effective and well accepted by patients.peer-reviewe

Dynamic mechanical response of polymer networks

The dynamic-mechanical response of flexible polymer networks is studied in the framework of tube model, in the limit of small affine deformations, using the approach based on Rayleighian dissipation function. The dynamic complex modulus G* is calculated from the analysis of a network strand relaxation to the new equilibrium conformation around the distorted primitive path. Chain equilibration is achieved via a sliding motion of polymer segments along the tube, eliminating the inhomogeneity of the polymer density caused by the deformation. The characteristic relaxation time of this motion separates the low-frequency limit of the complex modulus from the high-frequency one, where the main role is played by chain entanglements, analogous to the rubber plateau in melts. The dependence of storage and loss moduli, G' and G'', on crosslink and entanglement densities gives an interpolation between polymer melts and crosslinked networks. We discuss the experimental implications of the rather short relaxation time and the slow square-root variation of the moduli and the loss factor tan at higher frequencies.Comment: Journal of Chemical Physics (Oct-2000); Lates, 4 EPS figures include

Developing strategic learning alliances: partnerships for the provision of global education and training solutions

The paper describes a comprehensive model for the development of strategic alliances between education and corporate sectors, which is required to ensure effective provision of education and training programmes for a global market. Global economic forces, combined with recent advances in information and communication technologies, have provided unprecedented opportunities for education providers to broaden the provision of their programmes both on an international scale and across new sectors. Lifelong learning strategies are becoming increasingly recognized as an essential characteristic of a successful organization and therefore large organizations have shown a preparedness to invest in staff training and development. The demands for lifelong learning span a wide range of training and educational levels from school-level and vocational courses to graduate-level training for senior executive

Cylindrical shell hybrid finite elements

The work is concerned with the application of the hybrid finite element method to thin plate and cylindrical shell structures. One plate bending element and three shell elements are studied. The plate element is the same as one already appearing in the literature but it is also used here to form the basis of a flat triangular element for the analysis of shells. The main effort, however, has been devoted to the development of two new hybrid cylindrical shell elements. One is rectangular and the other of triangular planform. The aim has been to use fully compatible edge displacement assumptions (with exact representations of rigid body motions) together with stress assumptions consisting of complete polynomials. In assessing the performance of these elements the primary concern has been the quality of stress predictions. The two elements are tested separately on a variety of problems and found to give good results which compare well, in some cases, with those obtained using more complicated displacement assumption elements. They are the used together to analyse a cylinder intersection problem – that of a mitred bend in a pipe subjected to an in-plane bending moment. Results comparing well with some available strain gauge readings are obtained. As a result of the work some general conclusions on the hybrid method are drawn. More specific conclusions relating to these elements are also noted and suggestions for further work are made

Dual Labor Markets: A Theory of Labor Market Segmentation

A growing body of empirical research has documented persistent divisions among American workers: divisions by race, sex, educational credentials, industry grouping, and so forth (F. B. Weisskoff, B. Bluestone, S. Bowles and H. Gintis, D. Gordon, 1971 and 1972, B. Harrison, M. Reich, H. Wachtel and C. Betsey, and H. Zellner). These groups seem to operate in different labor markets, with different working conditions, different promotional opportunities, different wages, and different market institutions. These continuing labor market divisions pose anomalies for neoclassical economists. Orthodox theory assumes that profit-maximizing employers evaluate workers in terms of their individual characteristics and predicts that labor market differences among groups will decline over time because of competitive mechanisms (K. Arrow). But by most measures, the labor market differences among groups have not been disappearing (R. Edwards, M. Reich, and T. Weisskopf, chs. 5, 7, 8). The continuing importance of groups in the labor market thus is neither explained nor predicted by orthodox theory. Why is the labor force in general still so fragmented? Why are group characteristics repeatedly so important in the I labor market? In this paper, we summarize an emerging radical theory of labor market segmentation; we develop the full arguments in Reich, Gordon, and Edwards. The theory argues that political and economic forces within American capitalism have given rise to and perpetuated segmented labor markets, and that it is incorrect to view the sources of segmented markets as exogenous to the economic system

Limitations to Contingency Measures: Reflections from COVID-19 Surges in the UK

Alfandre et al. (2021) helpfully outlines the case for attending to contingency planning as well as to crisis measures during a pandemic. The authors provides a helpful framework for reflecting on the experiences of healthcare staff during COVID-19 to develop a more robust contingency phase. We do so, ourselves, in the context of the United Kingdom, particularly London where the prevalence of COVID-19 stretched resources despite considerable and continuing efforts to increase capacity as the depth of the crisis was understood. Recognizing the inevitable increase in cases once community transmission took hold, the UK government’s strategy was to keep case load manageably within the capacity of the National Health Service (NHS). All public health interventions were modeled and planned accordingly with insufficient regard to contingencies

Cylindrical shell hybrid finite elements

The work is concerned with the application of the hybrid finite element method to thin plate and cylindrical shell structures. One plate bending element and three shell elements are studied. The plate element is the same as one already appearing in the literature but it is also used here to form the basis of a flat triangular element for the analysis of shells. The main effort, however, has been devoted to the development of two new hybrid cylindrical shell elements. One is rectangular and the other of triangular planform. The aim has been to use fully compatible edge displacement assumptions (with exact representations of rigid body motions) together with stress assumptions consisting of complete polynomials. In assessing the performance of these elements the primary concern has been the quality of stress predictions. The two elements are tested separately on a variety of problems and found to give good results which compare well, in some cases, with those obtained using more complicated displacement assumption elements. They are the used together to analyse a cylinder intersection problem – that of a mitred bend in a pipe subjected to an in-plane bending moment. Results comparing well with some available strain gauge readings are obtained. As a result of the work some general conclusions on the hybrid method are drawn. More specific conclusions relating to these elements are also noted and suggestions for further work are made

How paradata can illuminate technical, social and professional role changes between the Poverty in the UK (1967/1968) and Poverty and Social Exclusion in the UK (2012) surveys

This article brings together analyses of the micro paradata ‘by-products’ from the 1967/1968 Poverty in the United Kingdom (PinUK) and 2012 Poverty and Social Exclusion in the UK (PSE) surveys to explore changes in the conditions of production over this 45 year period. We highlight technical, social and professional role continuities and changes, shaped by the institutionalisation of survey researchers, the professionalization of the field interviewer, and economisation. While there are similarities between the surveys in that field interviewers were and are at the bottom of the research hierarchy, we demonstrate an increasing segregation between the core research team and field interviewers. In PinUK the field interviewers are visible in the paper survey booklets; through their handwritten notes on codes and in written marginalia they can ‘talk’ to the central research team. In PSE they are absent from the computer mediated data, and from communication with the central team. We argue that, while there have been other benefits to field interviewers, their relational labour has become less visible in a shift from the exercise of observational judgement to an emphasis on standardisation. Yet, analyses of what field interviewers actually do show that they still need to deploy the same interpersonal skills and resourcefulness to secure and maintain interviews as they did 45 years previously