UK and Twenty Comparable Countries GDP-Expenditureon- Health 1980-2013: The Historic and Continued Low Priority of UK Health Related Expenditure

It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a ‘crisis’ point on account of low levels of funding. Indeed, many state that currently the NHS has a sizeable funding gap, in part due to its recently reduced GDP devoted to health but mainly the challenges around increases in longevity, expectation and new medical costs. The right level of health funding is a political value judgement. As the data in this paper outline, if the UK ‘afforded’ the same proportional level of funding as the mean average European country, total expenditure would currently increase by one-fifth

Socioeconomic indicators that matter for population health

Increasing research and policy attention is being given to how the socioeconomic environment influences health. This article discusses potential indicators or metrics regarding the socioeconomic environment that could play a role in an incentive-based system for population health. Given the state of the research regarding the influence of socioeconomic contextual variables on health outcomes, the state of data and metrics for these variables at the local level, and the potential for program and policy intervention, we recommend a set of metrics related to the socioeconomic composition of a community (including poverty, unemployment, and public assistance rates); educational attainment and achievement; racial segregation; and social-capital indicators such as density of voluntary organizations and voter turnout. These indicators reflect the evidence that population health gains depend on improvements in many of the fundamental social determinants of health, including meaningful employment, income security, educational opportunities, and engaged, active communities

Unsteady flow of a thixotropic fluid in a slowly varying pipe

We analyse the unsteady axisymmetric flow of a thixotropic or antithixotropic fluid in a slowly varying cylindrical pipe. We derive general perturbation solutions in regimes of small Deborah numbers, in which thixotropic or antithixotropic effects enter as perturbations to generalised Newtonian flow. We present results for the viscous Moore–Mewis–Wagner model and the viscoplastic Houška model, and we use these results to elucidate what can be predicted in general about the behaviour of thixotropic and antithixotropic fluids in lubrication flow. The range of behaviour we identify casts doubt on the efficacy of model reduction approaches that postulate a generic cross-pipe flow structure

Effects of landmark distance and stability on accuracy of reward relocation

This work was supported by the University of St Andrews, the University of Lethbridge and the Natural Sciences and Engineering Council of Canada.Although small-scale navigation is well studied in a wide range of species, much of what is known about landmark use by vertebrates is based on laboratory experiments. To investigate how vertebrates in the wild use landmarks, we trained wild male rufous hummingbirds to feed from a flower that was placed in a constant spatial relationship with two artificial landmarks. In the first experiment, the landmarks and flower were 0.25, 0.5 or 1 m apart and we always moved them 3–4 m after each visit by the bird. In the second experiment, the landmarks and flower were always 0.25 m apart and we moved them either 1 or 0.25 m between trials. In tests, in which we removed the flower, the hummingbirds stopped closer to the predicted flower location when the landmarks had been closer to the flower during training. However, while the distance that the birds stopped from the landmarks and predicted flower location was unaffected by the distance that the landmarks moved between trials, the birds directed their search nearer to the predicted direction of the flower, relative to the landmarks, when the landmarks and flower were more stable in the environment. In the field, then, landmarks alone were sufficient for the birds to determine the distance of a reward but not its direction.PostprintPostprintPeer reviewe

Compétences en santé mondiale en éducation médicale postdoctorale : un revue exploratoire et mise en correspondance le référentiel de compétences CanMEDS pour les médecins

Background: Global Health opportunities are popular, with many reported benefits. There is a need however, to identify and situate Global Health competencies within postgraduate medical education. We sought to identify and map Global Health competencies to the current CanMEDS physician competency framework to assess the degree of equivalency and uniqueness between them. Methods: JBI scoping review methodology was utilized to identify relevant papers searching MEDLINE, Embase, and Web of Science. Studies were reviewed independently by two of three researchers according to pre-determined eligibility criteria. Included studies identified competencies in Global Health training at the postgraduate medicine level, which were then mapped to the CanMEDS framework. Results: A total of 19 articles met criteria for inclusion (17 from literature search and 2 from manual reference review). We identified 36 Global Health competencies; the majority (23) aligned with CanMEDS competencies within the framework. Ten were mapped to CanMEDS roles but lacked specific key or enabling competencies, while three did not fit within the specific CanMEDS roles. Conclusions: We mapped the identified Global Health competencies, finding broad coverage of required CanMEDS competencies. We identified additional competencies for CanMEDS committee consideration and discuss the benefits of their inclusion in future physician competency frameworks.Contexte: Les opportunités de santé mondiale sont populaires, avec de nombreux avantages rapportés. Il est toutefois nécessaire d’identifier et de situer les compétences en santé mondiale dans la formation médicale postdoctorale. Nous avons cherché à identifier et à mapper les compétences en santé mondiale au cadre le référentiel CanMEDS d’évaluer le degré d’équivalence et d’unicité entre elles. Méthodologie : La méthodologie de revue exploratoire de JBI a été utilisée pour identifier les articles pertinents qui recherchent MEDLINE, Embase et Web of Science. Les études ont été examinées indépendamment par deux des trois chercheurs selon des critères d’admissibilité prédéterminés. Les études incluses ont permis d’identifier les compétences dans la formation en santé mondiale au niveau de la médecine postdoctorale, qui ont ensuite été mises en correspondance avec le cadre le référentiel CanMEDS. Résultats : Au total, 19 articles répondaient aux critères d’inclusion (17 provenant d’une recherche documentaire et 2 d’un examen manuel des références). Nous avons identifié 36 compétences en santé mondiale; la majorité (23) correspondait aux compétences CanMEDS dans le cadre. Dix d’entre eux ont été mappés à des rôles canMEDS, mais n’avaient pas de compétences clés ou habilitantes précises, tandis que trois ne correspondaient pas aux rôles spécifiques de CanMEDS. Conclusions : Nous avons cartographié les compétences en santé mondiale identifiées, en trouvant une large couverture des compétences CanMEDS requises. Nous avons identifié d’autres compétences à examiner par le comité CanMEDS et nous discutons des avantages de leur inclusion dans les futurs cadres de compétences des médecins

Development of a Mechanics Reasoning Inventory

Strategic knowledge is required to appropriately organize procedures and concepts to solve problems. We are developing a standardized instrument assessing strategic knowledge in the domain of introductory mechanics. This instrument is inspired in part by Lawson's Classroom Test of Scientific Reasoning and Van Domelen's Problem Decomposition Diagnostic. The predictive validity of the instrument has been suggested by preliminary studies showing significant correlation with performance on final exams administered in introductory mechanics courses at the Massachusetts Institute of Technology and the Georgia Institute of Technology. In order to study the validity of the content from the student's perspective, we have administered the instrument in free-response format to 40 students enrolled in calculus-based introductory mechanics at the University of Wisconsin-Platteville. This procedure has the additional advantage of improving the construct validity of the inventory, since student responses suggest effective distractors for the multiple-choice form of the inventory.National Science Foundation (U.S.) (PHY-0757931)National Science Foundation (U.S.) (DUE-1044294)National Institutes of Health (U.S.) (1-RC1-RR028302-01

Improved Student Performance In Electricity And Magnetism Following Prior MAPS Instruction In Mechanics

We examine the performance of a group of students in Introductory Electricity and Magnetism following a ReView course in Introductory Mechanics focusing on problem solving employing the Modeling Applied to Problem Solving (MAPS) pedagogy[1]. The group consists of students who received a D in the fall Mechanics course (8.01) and were given the chance to attend the ReView course and take a final retest. Improvement to a passing grade was qualification for the Electricity and Magnetism course (8.02) in the spring. The ReView course was conducted twice—during January 2009 and January 2010. As a control, we took a group of students with similar z-scores in 8.01 in Fall 2007 that were not offered the ReView course. We show that the ReView students perform ~0.7 standard deviations better than the control group (p~0.002) and ~0.5 standard deviations better than what is expected based on their performance in 8.01(p ~0.001).National Science Foundation (U.S.) (NSF grant # 0757931)National Institutes of Health (U.S.) (NIH grant # 1RC1RR028302-01