A Discrete Event Simulation model to evaluate the treatment pathways of patients with Cataract in the United Kingdom

Background The number of people affected by cataract in the United Kingdom (UK) is growing rapidly due to ageing population. As the only way to treat cataract is through surgery, there is a high demand for this type of surgery and figures indicate that it is the most performed type of surgery in the UK. The National Health Service (NHS), which provides free of charge care in the UK, is under huge financial pressure due to budget austerity in the last decade. As the number of people affected by the disease is expected to grow significantly in coming years, the aim of this study is to evaluate whether the introduction of new processes and medical technologies will enable cataract services to cope with the demand within the NHS funding constraints. Methods We developed a Discrete Event Simulation model representing the cataract services pathways at Leicester Royal Infirmary Hospital. The model was inputted with data from national and local sources as well as from a surgery demand forecasting model developed in the study. The model was verified and validated with the participation of the cataract services clinical and management teams. Results Four scenarios involving increased number of surgeries per half-day surgery theatre slot were simulated. Results indicate that the total number of surgeries per year could be increased by 40% at no extra cost. However, the rate of improvement decreases for increased number of surgeries per half-day surgery theatre slot due to a higher number of cancelled surgeries. Productivity is expected to improve as the total number of doctors and nurses hours will increase by 5 and 12% respectively. However, non-human resources such as pre-surgery rooms and post-surgery recovery chairs are under-utilized across all scenarios. Conclusions Using new processes and medical technologies for cataract surgery is a promising way to deal with the expected higher demand especially as this could be achieved with limited impact on costs. Non-human resources capacity need to be evenly levelled across the surgery pathway to improve their utilisation. The performance of cataract services could be improved by better communication with and proactive management of patients.Peer reviewedFinal Published versio

Gamification through leaderboards : an empirical study in engineering education

Universities are looking for solutions to engage more students in STEM domains and enhance their learning performance (LP). In this context, gamification is put forward as a solution to achieve this aim. The present study examined the effect of gamification – building on leaderboards ‐ on LP. Furthermore, mediating variables, such as intrinsic motivation, self‐efficacy, engagement, and background variables, such as sex, previous gaming experience, and undergraduate major, were considered. A pretest‐posttest quasi‐experimental design with an experimental and a control condition was set up (n = 89) in an Introductory Computer Programming course. We observed a significant improvement in the LP of students in the gamified condition. However, no interaction effect was detected, due to mediating and background variables. The high learning gain is a favorable indicator that gamification might be a promising approach to promote STEM programs

The Advent of the Transnational TV Format Trading System: A Global Commodity Chain Analysis

This article argues that the format business transformed into a trading system in the 2000s, system being defined as a singular transnational space structured by networks of interdependent economic agents, firms, institutions and places. Following the global commodity chain/global value chain approach set out by Immanuel Wallerstein and developed by Gary Gereffi, this article then examines each dimension of the global TV format commodity chain that runs through this trading system. Beginning with the governance structure, this article counter-intuitively asserts that despite the current boom in TV production, it is a buyer-driven chain with power resting firmly in the hands of those making the acquisitions: the broadcasters. Considering the chain’s geographical configuration, this article identifies three tiers of format exporters and specific trade routes along which most TV formats travel. These findings enable us to reassess the claims made by the cosmopolitanization thesis about the nature of media globalization. Contrary to this thesis, this article asserts the need to comprehend media globalization within the context of an expanding capitalist world-system, and shows that the new transnational TV format trade and its commodity chain replicate the inequalities and power structures of former trading systems

The making of an entertainment revolution: How the TV format trade became a global industry

From its humble origins in the 1950s, the TV format industry has become a global trade worth billions of Euros per year. Few viewers are aware that their favourite shows may be local adaptations but formats represent a significant percentage of European broadcasting schedules in access prime time and prime time. Formatted brands exist in all TV genres and reach almost every country in the world. This article defends the thesis that the format business turned into a global industry in the late 1990s. Before this turning point, the few formatted programmes were most likely American game shows that travelled slowly and to a limited number of territories. Following an overview of this early period, this article examines the convergence of factors that created a world format market. These include the emergence of four exceptional formats (Who Wants to Be a Millionaire?, Survivor, Big Brother and Idols), the formation of a programming market, the rise of the independent production sector, and the globalization of information flows within the TV industry

Television and Globalization: The TV Content Global Value Chain

This study uses the global value chain (GVC) framework to analyze the globalization of television and argues that it has been driven by the dynamics of a newly formed TV content value chain. Distinct segments emerged as the chain globalized and firms sought a competitive advantage by expanding internationally within their sector. This article focuses on four dimensions of the TV content value chain and, documenting the growth of transnational TV networks and formats, argues that the TV industry's millennial global shift was triggered by internationalization of the chain's segments. Finally, it suggests that industry conglomeration should be comprehended in the context of Internet disruption and international fragmentation of production within expanding value chains

A 'Different Class'? Homophily and Heterophily in the Social Class Networks of Britpop

Social network analysis is increasingly recognised as a useful way to explore music scenes. In this article we examine the individuals who were the cultural workforce that comprised the 'Britpop' music scene of the 1990s. The focus of our analysis is homophily and heterophily to determine whether the clusters of friendships and working relationships of those who were ‘best connected’ in the scene were patterned by original social class position. We find that Britpop's 'whole network' is heterophilic but its 'sub-networks' are more likely to be social class homophilic. The sub-networks that remain heterophilic are likely to be united by other common experiences that brought individuals in the network to the same social spaces. We suggest that our findings on Britpop might be generalised to the composition of other music scenes, cultural workforces and aggregations of young people. Our study differs from research on, first, British ‘indie music’ and social class which focusses upon the construction, representation and performance of social location rather than the relationships it might shape (such as Wiseman-Trowse, 2008) and second, the pioneering social network analyses of music scenes (such as Crossley 2008; 2009; 2015; Crossley et. al 2014) which currently lacks the explicit emphasis on social class

The rise of britain's super-indies: Policy-making in the age of the global media market

This article analyses Britain’s remarkable performance in the European television industry. In the space of a few years the UK has risen to become the world’s leading exporter of TV formats and the world’s second exporter, behind the Unites States, of finished TV programmes. The first section compares and contrasts British TV exports data with that of France, before examining the emergence of London as Europe’s media hub. The second part argues that this significant progress is essentially due to deft policy making. In 2003, the British government operated a strategic shift in favour of content producers and created a new intellectual property regime. This regime has enabled producers to keep hold of their rights and become asset-owning businesses, eventually giving rise to a new breed of production companies: the super-indies. This paper shows how these super-indies have acquired the scale to compete in an international TV market and drive today’s British TV exports. Contrasting again Britain’s performance in the European TV trade with France, this article also analyses historical influences and claims it is Britain’s imperial past that helps her performance in the European TV marketplace. In addition to the globalization of the English language and the cultural affinities this nurtures, the trading heritage of the British Empire has facilitated Britain’s political elite’s understanding of the role that trade and the market can play in the creative industries, and enabled them to frame a broadcasting policy that is adapted to the global age

Repelling neoliberal world-making? How the ageing–dementia relation is reassembling the social

Growing old ‘badly’ is stigmatizing, a truism that is enrolled into contemporary agendas for the biomedicalization of ageing. Among the many discourses that emphasize ageing as the root cause of later life illnesses, dementia is currently promoted as an epidemic and such hyperbole serves to legitimate its increasing biomedicalization. The new stigma however is no longer contained to simply having dementia, it is failing to prevent it. Anti-ageing cultures of consumption, alongside a proliferation of cultural depictions of the ageing–dementia relation, seem to be refiguring dementia as a future to be worked on to eliminate it from our everyday life. The article unpacks this complexity for how the ageing–dementia relation is being reassembled in biopolitics in ways that enact it as something that can be transformed and managed. Bringing together Bauman’s theories of how cultural communities cope with the otherness of the other with theories of the rationale for the making of monsters – such as the figure of the abject older person with dementia – the article suggests that those older body-persons that personify the ageing–dementia relation, depicted in film and television for example, threaten the modes of ordering underpinning contemporary lives. This is not just because they intimate loss of mind, or because they are disruptive, but because they do not perform what it is to be ‘response-able’ and postpone frailty through managing self and risk