Outliers in educational achievement data: Their potential for the improvement of performance

Statistical outliers (Barnett and Lewis, 1994) have customarily been identified as either potential threats to data integrity (Cook, 1977) or as potential distortions of estimates of central tendency (Strutz, 2010). In both circumstances outliers are treated as having nuisance value. On the other hand, Gladwell (2008) views outliers as success stories. The study adopts the latter approach to reach to classrooms and teachers which add value in student’s academic capabilities. Scores of 86207 students from 423 government schools in 2010 middle school (Grade VI to VIII) promotion examinations are analysed to explore the possibility of identifying gifted teachers.The study reports successful use of non-parametric methods of box plot and quartile formula to identify outstanding student performance. This performance is independent of overall school achievement, school size, student gender and is attributable to either individual or combined teaching effort

How can secondary care-based clinicians access and use primary care-held vaccination data during a Paediatric Emergency Department attendance?

Background Before the SARS-CoV2/COVID pandemic, in the UK, coverage for some routine childhood vaccines e.g. MMR (measles, mumps, and rubella), were below global targets. A visit to hospital might provide an opportunity to offer a “catch-up” intervention to under-immunised children and young people, if clinicians could accurately identify them. Aims The overall aims were to look at sources of vaccination data available to clinicians working in the Paediatric Emergency Department (PED) and explore how an intervention might address under-vaccination. Methods A multiple methods pilot explored the feasibility and acceptability of delivering a brief public health intervention within a PED attendance. A scoping review summarised evidence for the delivery of interventions in hospitals to improve vaccination uptake in children and young people (CYP). Unmet vaccination need in under-fives was estimated via a cross-sectional observational study with a single data collection point for participants attending a large PED in Greater Manchester, in October 2021. Sources of vaccination data explored were: parent/carer recall, Child Health Information Services (CHIS), and Summary Care Records (SCRs). This was via a cross-sectional observational study (recall and SCRs) and a systems mapping approach (for CHIS). Results This work demonstrated that it was feasible and acceptable to deliver an intervention during a PED attendance and that vaccination interventions in hospital settings may be beneficial. There was considerable unmet need amongst children under the age of five years old, attending the PED, with extremely low levels of MMR coverage amongst those old enough to be eligible for two doses. Vaccination status was often over-estimated by parents/carers, CHIS were a definitive source of vaccination data but inaccessible to PED clinicians, and data within SCRs were presented in an inconsistent manner and often unstructured. Conclusion Whilst delivery of a vaccination-focused intervention during a PED attendance appears feasible, more work is needed to enable clinicians to identify those CYP with unmet vaccination need who might benefit from such an approach

Suvremeni hrvatski liberalizam

Research shows a high level of commitment to liberal-democratic values among leading Croatian politicians, without regard to whether they are from the party in power or the opposition. As a rule most show greater democratic disposition than one would assume based on parliamentary debates or government policies. There are numerous reasons, but one of the key reasons is that democratic values are always harder to bring to reality in countries at war. Although the war continues, there are signs of a strengthening liberal alternative to the nationalist party in power. In this paper, I identify a cleavage between elites whose primary orientation is toward the ethnonational revolution and those committed to a liberal-democratic, pluralist civil-society model for Croatia. I describe the convergent values of Croatian liberalism, and discuss possible alliances creating a viable liberal opposition in the next elections.Istraživanje ukazuje na visoku razinu prihvaćanja liberalno-demokratskih vrijednosti medu vodećim hrvatskim političarima, bez obzira pripadaju li stranci na vlasti ili oporbi. U pravilu, većina ih iskazuje veće demokratske dispozicije no što bi se očekivalo na temelju parlamentarnih debata ili političkih poteza. Postoje brojni razlozi za to, no jedan od ključnih jest da je demokratske vrijednosti uvijek teže ostvariti u zemljama u ratu. Premda se rat nastavlja, postoje znakovi jačanja liberalne alternative nacionalističkoj stranci na vlasti. Autor identificira rascjep između političkih elita sklonih etnonacionalističkoj transformaciji te onih sklonih liberalno-demokratskom, pluralističkom i civilnom modelu. Rad opisuje konvergentne vrijednosti hrvatskog liberalizma i razmatra pitanje mogućih koalicija koje bi stvorile liberalni blok na sljedećim izborima

Interventions delivered in secondary or tertiary medical care settings to improve routine vaccination uptake in children and young people. A scoping review protocol

Objective: The objective of this review is to identify and collate the available evidence, and to produce an overview of interventions delivered in secondary and tertiary healthcare settings with the aim of improving vaccination uptake in children and young people. Introduction: Vaccine hesitancy appears in the World Health Organization's Ten Threats to Global Health in 2019.1 Time spent in secondary or tertiary healthcare settings with a child or young person may present an opportunity to deliver vaccination-focused interventions. National Institute for Health and Care Excellence guidance highlights a gap in the evidence of the effectiveness of different interventions aimed at increasing immunization uptake among children and young people.2 Inclusion criteria: Quantitative studies that describe interventions delivered in secondary and tertiary care settings will be included. Participants will include children and young people aged less than 16 years and/or their parents/carers (potentially interventions could be delivered to the child-parent/carer dyad) present in a secondary or tertiary care setting as either a patient or relative. Methods: This scoping review will be conducted using MEDLINE, CINAHL, Cochrane Library, Embase, Web of Science, as well as gray literature. The scoping review will exclude publications not available in English and any publication older than 30 years. Two reviewers will independently select articles using the inclusion criteria, based on their title and abstract. Data will be extracted from selected full text articles using a data extraction tool based on JBI recommendations. Study findings will be presented in tabular form detailing the interventions identified in the literature

Comparison of Escherichia coli virulence factors with colony morphology on various media

Call number: LD2668 .T4 1979 A278Master of Scienc

Outcome measures for use in trials of paediatric otorrhoea:A systematic review

Introduction:Paediatric otorrhoea (PO) describes a middle ear infection that results in a perforation of the tympanic membrane and ear discharge, in children and young people (CYP). Prolonged infection may be associated with hearing loss and developmental delay. The current management of paediatric otorrhoea is variable, including non-invasive treatments (conservative, oral antibiotics, topical antibiotics) and surgery, reflecting the lack of a sufficiently strong evidence base. Outcome reporting is fundamental to producing reliable and meaningful evidence to inform best practice.Objectives:Primary objective: to determine which outcome measures are currently used to evaluate treatment success in studies of non-surgical treatments for paediatric otorrhoea. Secondary objectives: to identify outcome measurement instruments used in the literature and assess their applicability for use in clinical trials of PO.Methods:This systematic review was registered with PROSPERO (CRD42023407976). Database searches of EMBASE, MEDLINE and Cochrane was performed on June 6, 2023, covering from Jan 1995 to May 2023. Randomised controlled trials or study protocols involving CYP with PO were included following PRISMA guidelines. Risk of bias was assessed with Cochrane's tool.Results:Of the 377 papers identified, six were included in the systematic review. The primary outcome of five of the studies related to otorrhoea cessation; both time to cessation and proportion recovered at various time points were used as measures. Two measurement instruments were identified: Otitis Media-6 Questionnaire and the Institute for Medical Technology Assessment Productivity Cost Questionnaire. Both were shown to be applicable measurement instruments when used in clinical trials of PO.Conclusions:To promote homogeneity and facilitate meaningful comparison and combination of studies, we propose that time to cessation of otorrhoea from onset of otorrhoea should be used as the primary outcome in future studies. Further research is needed to establish if this is the most important outcome to children and their caregivers

Retention of doctors in emergency medicine:a scoping review protocol

Objective: The primary question of the review is: What is known about retention of doctors in emergency medicine? Introduction: There is a staffing crisis in emergency medicine and retention problems across healthcare. The evidence is disparate and includes healthcare research, management studies and policy documents from government and other agencies. Therefore there is a need to map the evidence on retention of emergency medicine doctors. This review is part of a wider study of the retention of doctors in emergency medicine situated in the UK. Inclusion criteria: We will identify papers relating to emergency medicine doctors at all levels, using the different terms used internationally for these practitioners. We will exclude papers relating to other healthcare professions. We aim to include papers relating to retention; to identify these our search will include terms such as turnover and exodus. The setting is focused on the emergency department; studies focusing on working in other settings, for example, a minor injuries unit, will be excluded. Studies from any country will be included, however we are limited to those published in English. Methods: We will search medical literature databases including MEDLINE, Embase, HMIC, PsycINFO, the Cochrane Database of Systematic Reviews, and the British Medical Journal collection. We will supplement this by searching business and management journals including; Business Source Complete, ProQuest Business Database and Emerald Business and Management Journals. A structured iterative search of the gray literature will be conducted. Retrieved papers will be screened for inclusion by two reviewers. Data will be extracted and presented in tabular form and a narrative summary that align with the review's objective

Understanding responsibility for health inequalities in children’s hospitals in England : a qualitative study with hospital staff

Objectives This study aimed to understand how staff in children’s hospitals view their responsibility to reduce health inequalities for the children and young people who access their services. Design We conducted an exploratory qualitative study. Setting The study took place at nine children’s hospitals in England. Participants 217 members of staff contributed via interviews and focus groups conducted January–June 2023. Staff were represented at all levels of the organisations, and all staff who volunteered to contribute were included in the study. Analysis Data were analysed using Rapid Research Evaluation and Appraisal (RREAL) methodology for rapid assessment procedures (RAP). Results All of the children’s hospitals were taking some action to reduce health inequalities. Two key themes were identified. First, it was clear that reducing health inequalities was seen as something that was of vital import and should be part of staff’s day-to-day activity, framed as ‘everyone’s business.’ Many staff felt that there was an obligation to intervene to ensure that children and young people receiving hospital treatment were not further disadvantaged by, for example, food poverty. Second, however, the deeply entrenched and intersectional nature of health inequalities sometimes meant that these inequalities were complex to tackle, with no clear impetus to specific actions, and could be framed as ‘no-one’s responsibility’. Within a complex health and social care system, there were many potential actors who could take responsibility for reducing health inequalities, and staff often questioned whether it was the role of a children’s hospital to lead these initiatives. Conclusions Broadly speaking, senior leaders were clear about their organisational role in reducing health inequalities where they impacted on access and quality of care, but there was some uncertainty about the perceived boundaries of responsibility. This led to fragility in the sustainability of activity, and a lack of joined-up intervention. Most hospitals were forging ahead with activity, considering that it was more important to work to overcome health inequalities rather than debate whose job it was