Using self-categorization theory to uncover the framing of the 2015 Rugby World Cup: a cross-cultural comparison of three nations’ newspapers

Research into the framing of sporting events has been extensively studied to uncover newspaper bias in the coverage of global sporting events. Through discourse, the media attempt to capture, build, and maintain audiences for the duration of sporting events through the use of multiple narratives and/or storylines. Little research has looked at the ways in which the same event is reported across different nations, and media representations of the Rugby World Cup have rarely featured in discussions of the framing of sport events. The present study highlights the different ways in which rugby union is portrayed across the three leading Southern Hemisphere nations in the sport. It also shows the prominence of nationalistic discourse across those nations and importance of self-categorizations in newspaper narratives.</jats:p

Economic evaluation of cystic fibrosis screening: A Review of the literature, CHERE Working Paper 2006/6

Objectives: To critically examine the economic evidence on Cystic Fibrosis (CF) screening and to understand issues relating to the transferability of findings to the Australian context for policy decisions. Methods: A systematic literature search identified 25 economic studies with empirical results on CF published between 1990 and 2005. These articles were then assessed against international benchmarks on conducting and reporting of economic evaluations, focusing on the transferability of the evidence to the local setting. Results: Six studies described only costs, 12 were cost-effectiveness studies, 6 were cost-benefit studies and one had a combined design (cost utility, cost benefit and cost effectiveness). Most of the cost-effectiveness studies compared screening versus ?no-screening? but the screening programs under consideration differed markedly. Four considered neonatal screening, three prenatal screening, three pre-conception and carrier screening, and one considered all types of screening programs. The outcome measures also varied considerably between studies. One study included a quality adjusted life year measure. Cost?benefit measures mostly included economic savings ? evaded lifetime medical costs of avoiding CF child birth. Conclusion: The variability in study design, model inputs and reporting of economic evaluations of CF carrier screening raises issues on the applicability and transferability of such evidence to the Australian context.Cystic fibrosis, economic evaluation

a secondary analysis of two pharmacokinetic studies in surgical ICU patients

Background In ICU patients, glomerular filtration is often impaired, but also supraphysiological values are observed (“augmented renal clearance”, >130 mL/min/1.73 m2). Renally eliminated drugs (e.g. many antibiotics) must be adjusted accordingly, which requires a quantitative measure of renal function throughout all the range of clinically encountered values. Estimation from plasma creatinine is standard, but cystatin C may be a valuable alternative. Methods This was a secondary analysis of renal function parameters in 100 ICU patients from two pharmacokinetic studies on vancomycin and betalactam antibiotics. Estimated clearance values obtained by the Cockcroft-Gault formula (eCLCG), the CKD-EPI formula (eCLCKD-EPI) or the cystatin C based Hoek formula (eCLHoek) were compared with the measured endogenous creatinine clearance (CLCR). Agreement of values was assessed by modified Bland-Altman plots and by calculating bias (median error) and precision (median absolute error). Sensitivity and specificity of estimates to identify patients with reduced (130 mL/min/1.73 m2) CLCR were calculated. Results The CLCR was well distributed from highly compromised to supraphysiological values (median 73.2, range 16.8-234 mL/min/1.73 m2), even when plasma creatinine was not elevated (≤0.8 mg/dL for women, ≤1.1 mg/dL for men). Bias and precision were +13.5 mL/min/1.73 m2 and ±18.5 mL/min/1.73 m2 for eCLCG, +7.59 and ±16.8 mL/min/1.73 m2 for eCLCKD-EPI, and -4.15 and ±12.9 mL/min/1.73 m2 for eCLHoek, respectively, with eCLHoek being more precise than the other two (p < 0.05). The central 95% of observed errors fell between -59.8 and +250 mL/min/1.73 m2 for eCLCG, -83.9 and +79.8 mL/min/1.73 m2 for eCLCKD-EPI, and -103 and +27.9 mL/min/1.73 m2 for eCLHoek. Augmented renal clearance was underestimated by eCLCKD-EPI and eCLHoek. Patients with reduced CLCR were identified with good specificity by eCLCG, eCLCKD-EPI and eCLHoek (0.95, 0.97 and 0.91, respectively), but with less sensitivity (0.55, 0.55 and 0.83). For augmented renal clearance, specificity was 0.81, 0.96 and 0.96, but sensitivity only 0.69, 0.25 and 0.38. Conclusions Normal plasma creatinine concentrations can be highly misleading in ICU patients. Agreement of the cystatin C based eCLHoek with CLCR is better than that of the creatinine based eCLCG or eCLCKD-EPI. Detection and quantification of augmented renal clearance by estimates is problematic, and should rather rely on CLCR

How improving access times had unforeseen consequences:a case study in a Dutch hospital

Objectives To investigate the consequences of increasing capacity to reduce access times, and to explore how patient waiting times and use of physical capacity were influenced by variability. Design A retrospective case study that combines both primary and secondary data. Secondary data were retrieved from a hospital database to establish inflow and outflow of patients, utilisation of resources and available capacity, realised access times and the weekly number of new patients seen over 1 year. Primary data consisted of field notes, onsite visits and observations, and semistructured interviews. Setting A secondary care facility, that is, a rheumatology department, in a large Dutch hospital. Participants Analyses are based on secondary patient data from the hospital database, and the responses of the interviews with physicians, nurses and Lean Six Sigma project leaders. Results The study shows that artificial variability was increased by managerial decisions to add capacity and to allow an increased inflow of new patients. This, in turn, resulted in undesirable and significant fluctuations in access times. We argue that we witnessed a new multiplier effect that typifies the fluctuations. Conclusions Adding capacity resources to reduce access times might appear an obvious and effective solution. However, the outcomes were less straightforward than expected, and even led to new artificial variability. The study reveals a phenomenon that is specific to service environments, and especially healthcare, and has detrimental consequences for access times

Training mathematical skills for physics by means of a web-based tool

This article describes the use of a web-based course to enhance the learning of mathematical concepts and skills in a university Physics course. Both the coupling of a symbolic language (Maple) and adequate feedback enable to simulate in a computer program the way students should perform. The learning effect which is aimed for is to improve both concepts and skills. Moreover, this tool helps to correct possible misunderstandings or misconceptions. Web-based training was offered in an electromagnetism course. The training consists of several exercises which focus on applying complex mathematical skills in the field of electromagnetism, one at a time

Kwaliteit en kosten in instellingen voor klinische zorg. Eindrapportage van de toepassing van een kwaliteitsmodel in 5 Nederlandse zorginstellingen 1999-2002

In dit rapport wordt verslag gedaan van de bruikbaarheid en toepasbaarheid van het kwaliteitskostenmodel in de praktijk. Het verslag bestaat uit 2 delen: 1) Externe verslagen over het verloop en de resultaten binnen de kwaliteitsprojecten in de zorginstellingen door de projectteams. 2) Een procesevaluatie met name gericht op de toepassing en het gebruik van kwaliteitskosten bij de uitvoering van de kwaliteitsprojecten. Algemeen blijkt het kwaliteitskostenmodel in de praktijk uitvoerbaar: met behulp van kwaliteitskosteninformatie kunnen knelpunten binnen het zorgproces aangewezen worden en kunnen prioriteiten voor verbetering worden gesteld. De toepasbaarheid van de kwaliteitskosteninformatie voor de besluitvorming binnen de kwaliteitsprojecten is nog beperkt. Hierbij spelen zowel een aantal interne als externe factoren een rol die belemmerend werken: 1) Betrokkenen zijn niet kosten-minded ingesteld, waardoor terughoudend wordt omgegaan met kostenargumenten. 2) Kostenargumenten als zodanig blijken niet direct bruikbaar als motiverend argument om draagvlak te krijgen voor kwaliteitsverbeteringen. 3) Het ontbreekt binnen de zorginstellingen veelal aan een ‘outcome’-gerichtheid die de basis vormt van de werking van het kwaliteitskostenmodel. 4) De huidige Functiegerichte Budgettering biedt weinig prikkels om vermijdbare kosten binnen het zorgproces te doen dalen of om te komen tot omzetvergroting. In het algemeen gaat de aandacht vooral uit naar mogelijkheden voor financiële besparingen (beïnvloeding op geldstromen). De mogelijke economische besparingen vragen om topdown ondersteuning en sturing vanuit het management. Daarnaast vraagt de toepassing van de methode expertise om consequenties van financiële en economische kosten in te passen in beleidsbeslissingen binnen de zorginstellingen