Using action research to design and evaluate sustained and inclusive engagement to improve children’s knowledge and perception of STEM careers

Previous research suggests that early experience of and exposure to the world of work is an important predictor of a child’s future involvement in a STEM career. Many interventions have focused on those in secondary education age 11 years and above. Far fewer interventions have explored the impact of STEM outreach engagements among younger age groups. This study investigates the impact of a project that delivered career-driven STEM interventions on young children’s (7–10 years old) career knowledge and perceptions over time. Using an action research approach, this study outlines 10 distinct features for designing child-centred STEM interventions. These were delivered in 6 primary schools across North-East England over a 2-year period. A STEM Career Knowledge and Aspirations Tool was used to collect data to evaluate the impact of these interventions. Children sorted 30 job cards (mix of STEM and non-STEM) into jobs they knew, and also into jobs they would like to do. Baseline data and follow up data were collected in 2015 (n = 352) and 2017 (n = 356). Data analysis suggests the sustained interventions had a particularly positive effect on girls. In 2015 prior to the interventions, girls were significantly less likely than boys to know the following STEM jobs: surveyor, technician and game tester. In 2017, following the sustained intervention, there was no significant difference between boys and girls. Furthermore, one of the STEM jobs, Engineer, showed the greatest increase in the percentage of boys and girls that wanted to do it in 2017 compared to 2015

The NUSTEM Approach: Tackling the Engineering and Gender Challenge Together from Early Years to Sixth Form and beyond

Despite significant investment in initiatives to increase participation and diversity in physical and computer sciences, technology and engineering, there has not been a corresponding increase in the number of young people choosing these subjects, and a strong gender imbalance remains. NUSTEM, a collaborative widening participation and outreach initiative at Northumbria University, believes a radical rethink is necessary to solve this engineering challenge. NUSTEM is investing in the next generation by working extensively with young people and their key influencers: parents, carers and teachers, from primary school to sixth form and beyond. Building on their own original research and experience combined with previous research and recommendation from others, NUSTEM has developed an innovative model of practice and theory of change. This paper identifies the evidence that has informed the development of the approach and outlines three key requirements for increasing the uptake of physical and computer sciences, technology and engineering by young people from under-represented groups

Inclusive teaching in science: Changing culture and practice

Carol Davenport and Annie Padwick consider how we can make science teaching inclusive for all the children in our classroom

Tackling the digital and engineering skills shortage: Understanding young people and their career aspirations

Machines, algorithms and people are coming together in new and exciting ways. This is changing the world of work with new jobs previously unimagined. It is crucial that we prepare our young people for this world, yet many of them do not aspire to, and are not choosing, careers in digital technology or engineering, particularly girls and those from socially-disadvantaged backgrounds. Furthermore, while much of the work in this area has focused on the aspirations of older children there is evidence that children’s aspirations are formed at an early age. The aim of this study is to explore the factors that influence younger children’s reported aspirations to jobs, and in particular STEM jobs. Data was gathered from children aged 7-11 (n= 622) across areas of deprivation in North East England. Children were asked about their career aspirations and the motivations behind these. Analysis of this data showed that the majority of children were aspirational in their career choices, with many reporting higher aspirations than their parents’ current jobs. A gender difference was evident across both aspirations and motivations, with many girls choosing STEM careers that help others. Very few of the children aspired to jobs in the digital and engineering sectors. These results demonstrate the criticality of early education stages are for children’s developing aspirations and the urgent need to adapt education so that all children, irrespective of gender or background, can be supported to grasp the opportunities presented by an ever-changing world

Scientist of the week: evaluating effects of a teacher-led STEM intervention to reduce stereotypical views of scientists in young children

Background: Previous research into children’s perceptions of science shows that children like science but often hold stereotypical views of scientists and commonly do not see themselves with a career as a scientist.Purpose: The aim of this study is to examine if a carefully designed medium-term, teacher-led STEM intervention, ‘Scientist of the Week’ which showcased a diverse range of working scientists and the skills they need, can lead to a positive change in the perception of scientists among young people.Sample Design and Methods: Using a case-control approach, this research used a tracked sample of 118 young people from aged 7 to 11 in a primary school in the North East of England. Words associated with scientists were collected before and after (directly, one month, one year) the intervention from the tracked sample and analysed to assess changes in stereotypical perceptions and any difference in responses between male and female participants.Results: Before the intervention, young children held many of the common stereotypes associated with scientists. Shortly afterwards, and one year following the intervention, the use of common stereotypes had fallen significantly across all children, with particular improvements in counter-stereotypical word usage for males. It also found that stereotypical images of scientists as highly intelligent were more difficult to counteract and that many of the positive changes in this view seen in the short term (weeks and months) diminished in the long term (one year later).Conclusions: This research has shown that with minimal expense and effort from teachers, negative stereotypes of scientists can be reduced through an intervention that does not require bringing scientists into the classroom. Some of the observed changes persisted in the longer-term, suggesting a lasting alteration in children’s perceptions of scientists following the interventio

A Theory of Change for Improving Children’s Perceptions, Aspirations and Uptake of STEM Careers

There is concern about the low numbers and diversity of young people choosing careers and study subjects in science, technology, engineering and maths (STEM) at university and beyond. Many interventions aimed at addressing this issue have focused on young people aged 14+ years old. However, these interventions have resulted in little improvement in the numbers and diversity of young people progressing into STEM careers. The aim of this study is to ask “What are the affordances of a Theory of Change (ToC) for increasing the diversity and number of young people choosing a career in STEM post-18?” An innovative ToC is introduced which provides the theoretical underpinnings and context for the complex mix of interventions necessary to lead to a significant change in the number and diversity of those choosing STEM careers. Case studies of interventions developed using the ToC are presented. This approach, and associated ToC, is widely applicable across STEM, education and public engagement fields

Effectiveness of Compounded Bioidentical Hormone Replacement Therapy: An Observational Cohort Study

<p>Abstract</p> <p>Background</p> <p>Bioidentical Hormone Replacement Therapy (BHRT) is believed it to be a safer and equally effective alternative to Conventional Hormone Therapy for the relief of menopausal symptoms; however, data are needed to support these claims. The objective of this study is to evaluate the effectiveness of compounded BHRT provided in six community pharmacies.</p> <p>Methods</p> <p>This was an observational cohort study of women between the ages of 18-89 who received a compounded BHRT product from January 1, 2003 to April 30, 2010 in six community pharmacies. Data included patient demographics, comorbidities, therapeutic outcomes, and hormone therapies. Women self-rated menopausal symptoms as absent, mild, moderate, or severe. Descriptive statistics were used to characterize the patient population, BHRT use, and adverse events. Patient symptom severity was compared at baseline and 3 to 6 months follow-up using the Wilcoxon signed-rank test.</p> <p>Results</p> <p>Women (n = 296) receiving BHRT at Oakdell Pharmacy had a mean (standard deviation) age of 52 (9) years. The most common BHRT dosage forms utilized were topical (71%) and oral (43%). Compounded BHRT regimens were generally initiated at low doses regardless of route. Women experienced a 25% decrease in emotional lability (p < 0.01), a 25% decrease in irritability (p < 0.01), and a 22% reduction in anxiety (p = 0.01) within 3 to 6 months. These women also experienced a 14% reduction in night sweats (p = 0.09) and a 6% reduction in hot flashes (p = 0.50).</p> <p>Conclusions</p> <p>This study demonstrates that compounded BHRT improves mood symptoms. Larger studies are needed to examine the impact on vasomotor symptoms, myocardial infarction and breast cancer.</p

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Maximal-effort cytoreductive surgery for ovarian cancer patients with a high tumor burden: variations in practice and impact on outcome

Background This study aimed to compare the outcomes of two distinct patient populations treated within two neighboring UK cancer centers (A and B) for advanced epithelial ovarian cancer (EOC). Methods A retrospective analysis of all new stages 3 and 4 EOC patients treated between January 2013 and December 2014 was performed. The Mayo Clinic surgical complexity score (SCS) was applied. Cox regression analysis identified the impact of treatment methods on survival. Results The study identified 249 patients (127 at center A and 122 in centre B) without significant differences in International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO 4, 29.7% at centers A and B), Eastern Cooperative Oncology Group (ECOG) performance status (ECOG < 2, 89.9% at centers A and B), or histology (serous type in 84.1% at centers A and B). The patients at center A were more likely to undergo surgery (87% vs 59.8%; p < 0.001). The types of chemotherapy and the patients receiving palliative treatment alone were equivalent between the two centers (3.6%). The median SCS was significantly higher at center A (9 vs 2; p < 0.001) with greater tumor burden (9 vs 6 abdominal fields involved; p < 0.001), longer median operation times (285 vs 155 min; p < 0.001), and longer hospital stays (9 vs 6 days; p < 0.001), but surgical morbidity and mortality were equivalent. The independent predictors of reduced overall survival (OS) were non-serous histology (hazard ratio [HR], 1.6; 95% confidence interval [CI] 1.04–2.61), ECOG higher than 2 (HR, 1.9; 95% CI 1.15–3.13), and palliation alone (HR, 3.43; 95% CI 1.51–7.81). Cytoreduction, of any timing, had an independent protective impact on OS compared with chemotherapy alone (HR, 0.31 for interval surgery and 0.39 for primary surgery), even after adjustment for other prognostic factors. Conclusions Incorporating surgery into the initial EOC management, even for those patients with a greater tumor burden and more disseminated disease, may require more complex procedures and more resources in terms of theater time and hospital stay, but seems to be associated with a significant prolongation of the patients overall survival compared with chemotherapy alone. Maximal-effort cytoreductive surgery aimed at total macroscopic tumor clearance combined with platinum-based chemotherapy and targeted agents is the cornerstone of modern primary epithelial ovarian cancer (EOC) management.1 Although findings have shown high tumor burden to be associated with a less favorable overall outcome than more advantageous tumor dissemination patterns with less disease,2 multiple prospective and retrospective series have long demonstrated a strong positive association between total macroscopic tumor clearance rates and survival, not only on an individual basis but also at the level of large patient cohorts, in which individual tumor biology-related factors are less likely to skew collective survival data.1,3, 4, 5, 6, 7, 8 The team of Chi et al. recently presented the survival data for all advanced EOC patients treated at Memorial Sloan Kettering categorized by year of primary debulking surgery based on the implementation of surgical changes in their approach to ovarian cancer debulking. Their study demonstrated that complete gross resection rates, progression-free survival (PFS) and overall survival (OS) increased during the 13-year evaluation period despite operating on higher-stage disease and patients with a greater tumor burden. This was assumed to be largely attributable to the surgical paradigm shifts implemented specifically to achieve more complete surgical cytoreduction, even for patients with a less favorable disease profile.4 Nevertheless, as with all medical and surgical advances, their broader implementation varies greatly nationally and internationally, not just due to differences in the available resources, but also because of long-established local practice and broad disparities in overall philosophy as well as in individual and infrastructural expertise.3,6,8,9 Especially for patients with a high tumor burden, in which therapeutic effort often is challenged, not only by the disease itself but also by the impact that this advanced disease has on the actual patient, both personal and infrastructural resources and expertise often are stretched, and hence reasonable doubt arises about the limitations and limits of optimal treatment.2,3,6 The current analysis aimed to demonstrate how differences in local practice may influence the patient’s outcome by evaluating not only the surgical patients, but also the entire EOC cohort treated at one of two large UK cancer centers in an attempt to exclude a selection bias of seemingly more favorable and operable patients7,10,11 and have all ovarian cancer patients in the denominator, including those women with more adverse tumor profiles and higher tumor load