Implementing a 48 h EWTD-compliant rota for junior doctors in the UK does not compromise patients’ safety : assessor-blind pilot comparison

Background: There are currently no field data about the effect of implementing European Working Time Directive (EWTD)-compliant rotas in a medical setting. Surveys of doctors’ subjective opinions on shift work have not provided reliable objective data with which to evaluate its efficacy. Aim: We therefore studied the effects on patient's safety and doctors’ work-sleep patterns of implementing an EWTD-compliant 48 h work week in a single-blind intervention study carried out over a 12-week period at the University Hospitals Coventry & Warwickshire NHS Trust. We hypothesized that medical error rates would be reduced following the new rota. Methods: Nineteen junior doctors, nine studied while working an intervention schedule of <48 h per week and 10 studied while working traditional weeks of <56 h scheduled hours in medical wards. Work hours and sleep duration were recorded daily. Rate of medical errors (per 1000 patient-days), identified using an established active surveillance methodology, were compared for the Intervention and Traditional wards. Two senior physicians blinded to rota independently rated all suspected errors. Results: Average scheduled work hours were significantly lower on the intervention schedule [43.2 (SD 7.7) (range 26.0–60.0) vs. 52.4 (11.2) (30.0–77.0) h/week; P < 0.001], and there was a non-significant trend for increased total sleep time per day [7.26 (0.36) vs. 6.75 (0.40) h; P = 0.095]. During a total of 4782 patient-days involving 481 admissions, 32.7% fewer total medical errors occurred during the intervention than during the traditional rota (27.6 vs. 41.0 per 1000 patient-days, P = 0.006), including 82.6% fewer intercepted potential adverse events (1.2 vs. 6.9 per 1000 patient-days, P = 0.002) and 31.4% fewer non-intercepted potential adverse events (16.6 vs. 24.2 per 1000 patient-days, P = 0.067). Doctors reported worse educational opportunities on the intervention rota. Conclusions: Whilst concerns remain regarding reduced educational opportunities, our study supports the hypothesis that a 48 h work week coupled with targeted efforts to improve sleep hygiene improves patient safety

Assistive tool for collaborative learning of conceptual structures

The final publication is available at link.springer.comThere is a demand for computational methods assisting learners to generate relevantassociations for current context. Many concepts in natural language have ambiguous meaningsimplying alternative ways to define associations for them. It is crucial to develop collaborativemethods that support free experiments with promising conceptual structures in learning.Methods for evaluating these structures in respect to the person’s needs are also required. Wepropose a new collaborative ideation scheme and based on that we have implemented anassistive tool for learning conceptual structures in a collaborative Web environment.Peer reviewe

The relationship between the perception of distributed leadership in secondary schools and teachers' and teacher leaders' job satisfaction and organizational commitment

This study investigates the relation between distributed leadership, the cohesion of the leadership team, participative decision-making, context variables, and the organizational commitment and job satisfaction of teachers and teacher leaders. A questionnaire was administered to teachers and teacher leaders (n=1770) from 46 large secondary schools. Multiple regression analyses and path analyses revealed that the study variables explained significant variance in organizational commitment. The degree of explained variance for job satisfaction was considerably lower compared to organizational commitment. Most striking was that the cohesion of the leadership team and the amount of leadership support was strongly related to organizational commitment, and indirectly to job satisfaction. Decentralization of leadership functions was weakly related to organizational commitment and job satisfaction

‘Scaling up’ educational change: some musings on misrecognition and doxic challenges

Educational policy-makers around the world are strongly committed to the notion of ‘scaling up’. This can mean anything from encouraging more teachers to take up a pedagogical innovation, all the way through to system-wide efforts to implement ‘what works’ across all schools. In this paper, I use Bourdieu’s notions of misrecognition to consider the current orthodoxies of scaling up. I argue that the focus on ‘process’ and ‘implementation problems’: (1) both obscures and legitimates the ways in which the field logics of practice actually work and, (2) produces/reproduces the inequitable distribution of educational benefits (capitals and life opportunities). I suggest that the notion of misrecognition might provide a useful lens through which to examine reform initiatives and explanations of their success/failure

A model for the consolidation of rafted sea ice

Rafting is one of the important deformation mechanisms of sea ice. This process is widespread in the north Caspian Sea, where multiple rafting produces thick sea ice features, which are a hazard to offshore operations. Here we present a one-dimensional, thermal consolidation model for rafted sea ice. We consider the consolidation between the layers of both a two-layer and a three-layer section of rafted sea ice. The rafted ice is assumed to be composed of layers of sea ice of equal thickness, separated by thin layers of ocean water. Results show that the thickness of the liquid layer reduced asymptotically with time, such that there always remained a thin saline liquid layer. We propose that when the liquid layer is equal to the surface roughness the adjacent layers can be considered consolidated. Using parameters representative of the north Caspian, the Arctic, and the Antarctic, our results show that for a choice of standard parameters it took under 15 h for two layers of rafted sea ice to consolidate. Sensitivity studies showed that the consolidation model is highly sensitive to the initial thickness of the liquid layer, the fraction of salt release during freezing, and the height of the surface asperities. We believe that further investigation of these parameters is needed before any concrete conclusions can be drawn about rate of consolidation of rafted sea ice features

Recent acquisition of Helicobacter pylori by Baka Pygmies

Both anatomically modern humans and the gastric pathogen Helicobacter pylori originated in Africa, and both species have been associated for at least 100,000 years. Seven geographically distinct H. pylori populations exist, three of which are indigenous to Africa: hpAfrica1, hpAfrica2, and hpNEAfrica. The oldest and most divergent population, hpAfrica2, evolved within San hunter-gatherers, who represent one of the deepest branches of the human population tree. Anticipating the presence of ancient H. pylori lineages within all hunter-gatherer populations, we investigated the prevalence and population structure of H. pylori within Baka Pygmies in Cameroon. Gastric biopsies were obtained by esophagogastroduodenoscopy from 77 Baka from two geographically separated populations, and from 101 non-Baka individuals from neighboring agriculturalist populations, and subsequently cultured for H. pylori. Unexpectedly, Baka Pygmies showed a significantly lower H. pylori infection rate (20.8%) than non-Baka (80.2%). We generated multilocus haplotypes for each H. pylori isolate by DNA sequencing, but were not able to identify Baka-specific lineages, and most isolates in our sample were assigned to hpNEAfrica or hpAfrica1. The population hpNEAfrica, a marker for the expansion of the Nilo-Saharan language family, was divided into East African and Central West African subpopulations. Similarly, a new hpAfrica1 subpopulation, identified mainly among Cameroonians, supports eastern and western expansions of Bantu languages. An age-structured transmission model shows that the low H. pylori prevalence among Baka Pygmies is achievable within the timeframe of a few hundred years and suggests that demographic factors such as small population size and unusually low life expectancy can lead to the eradication of H. pylori from individual human populations. The Baka were thus either H. pylori-free or lost their ancient lineages during past demographic fluctuations. Using coalescent simulations and phylogenetic inference, we show that Baka almost certainly acquired their extant H. pylori through secondary contact with their agriculturalist neighbors

Search for the Higgs boson in events with missing transverse energy and b quark jets produced in proton-antiproton collisions at s**(1/2)=1.96 TeV

We search for the standard model Higgs boson produced in association with an electroweak vector boson in events with no identified charged leptons, large imbalance in transverse momentum, and two jets where at least one contains a secondary vertex consistent with the decay of b hadrons. We use ~1 fb-1 integrated luminosity of proton-antiproton collisions at s**(1/2)=1.96 TeV recorded by the CDF II experiment at the Tevatron. We find 268 (16) single (double) b-tagged candidate events, where 248 +/- 43 (14.4 +/- 2.7) are expected from standard model background processes. We place 95% confidence level upper limits on the Higgs boson production cross section for several Higgs boson masses ranging from 110 GeV/c2 to 140 GeV/c2. For a mass of 115 GeV/c2 the observed (expected) limit is 20.4 (14.2) times the standard model prediction.Comment: 8 pages, 2 figures, submitted to Phys. Rev. Let

Observation and Mass Measurement of the Baryon Ξb−\Xi^-_b

We report the observation and measurement of the mass of the bottom, strange baryon $\Xi^-_b$ through the decay chain $\Xi^-_b \to J/\psi \Xi^-$, where $J/\psi \to \mu^+ \mu^-$, $\Xi^- \to \Lambda \pi^-$, and $\Lambda \to p \pi^-$. Evidence for observation is based on a signal whose probability of arising from the estimated background is 6.6 x 10^{-15}, or 7.7 Gaussian standard deviations. The $\Xi^-_b$ mass is measured to be $5792.9\pm 2.5$ (stat.) $\pm 1.7$ (syst.) MeV/$c^2$.Comment: Minor text changes for the second version. Accepted by Phys. Rev. Let

Polarizations of J/psi and psi(2S) Mesons Produced in ppbar Collisions at 1.96 TeV

We have measured the polarizations of \jpsi and \psiprime mesons as functions of their transverse momentum \pt when they are produced promptly in the rapidity range $|y|<0.6$ with \pt \geq 5 \pgev. The analysis is performed using a data sample with an integrated luminosity of about 800 \ipb collected by the CDF II detector. For both vector mesons, we find that the polarizations become increasingly longitudinal as \pt increases from 5 to 30 \pgev. These results are compared to the predictions of nonrelativistic quantum chromodynamics and other contemporary models. The effective polarizations of \jpsi and \psiprime mesons from $B$-hadron decays are also reported.Comment: 8 pages, 7 figures, published in Physical Review Letter

Search for Third Generation Vector Leptoquarks in p anti-p Collisions at sqrt(s) = 1.96 TeV

We describe a search for a third generation vector leptoquark (VLQ3) that decays to a b quark and tau lepton using the CDF II detector and 322 pb^(-1) of integrated luminosity from the Fermilab Tevatron. Vector leptoquarks have been proposed in many extensions of the standard model (SM). Observing a number of events in agreement with SM expectations, assuming Yang-Mills (minimal) couplings, we obtain the most stringent upper limit on the VLQ3 pair production cross section of 344 fb (493 fb) and lower limit on the VLQ3 mass of 317 GeV/c^2 (251 GeV/c^2) at 95% C.L.Comment: 7 pages, 2 figures, submitted to PR