The political economy of environmental technological change with a case study of the power sector in Vietnam

The escalating imperative of climate change mitigation implies a substantial change in the technologies of electricity generation and supply in industrialised and industrialising countries alike. Understanding how to effect this technological change is therefore imperative if the challenge of climate change is to be addressed. The literature is replete with technology and policy studies investigating technologies, policy instruments and processes of technological change, however, surprisingly little research has addressed the broader political economy context within which any technological change will need to be realised. This research investigates linkages between the sort of systematic environmental technological change implied by the imperative of climate change mitigation and the broader political economy context. Firstly, considering evolutionary economics approaches to understanding technological change, we argue that evolutionary micro-foundations lend themselves to an analysis of political economy processes. Moreover, it is a direct consequence of evolutionary microfoundations that technological change, and particularly that linked with structural change in an economy, is likely to have important political economy implications. Secondly, we show how heterodox approaches to understanding structural change and development in economic systems are consistent with evolutionary micro-foundations and allow the development of an analytical framework based upon an understanding of the process of economic rent creation and preservation. Thirdly, we apply these insights to a critical reconstruction of the evidence on the development of the electricity services industry (ESI), illustrating the importance of political economy considerations in understanding technological and institutional change in that sector. Finally, we apply these insights to a detailed case study of the ESI in Vietnam, investigating the ways in which political economy factors have influenced the broader development of the sector, and examining how the choice of specific technologies is likely to be affected by political economy of the sector

Psychosocial Determinants of Health in Recreational, Tactical, and Competitive Athletes: Implications for Physical Therapists

Neuromusculoskeletal (NMSK) injuries are ubiquitous in recreational, tactical, and competitive athletes. Many athletes who sustain a NMSK injury progress to develop chronic conditions that can limit physical activity and result in substantial long-term disability. Both social and psychological factors may drive care-seeking and treatment compliance following NMSK injury, as well as contribute to the chronification of injury. In turn, each of these factors could result in long-term cardiovascular consequences that contribute to morbidity and mortality over a lifetime. Physical therapists have a professional duty to work in communities, operational military units, and in competitive athletic programs to increase accessibility, foster care-seeking behaviors, and mitigate potential long-term consequences following NMSK injury. All practitioners should be aware that successful rehabilitation includes consideration of many complex biopsychosocial, technical, and operational factors. In this educational session, we will discuss the unique psychological and social determinants of health in recreational, tactical, and competitive athletes. This session will include specific suggestions about techniques physical therapists can employ to facilitate care-seeking following NMSK injury

MK3: On optimizing the management of cascades or systems of reservoirs at catchment level

This project is about scaling up to the catchment level the results obtained from optimizing the management of individual reservoirs. As such, it draws on results from MKs 1 and 2. It seeks to understand at the catchment scale the cumulative upstream and downstream consequences of management decisions taken for multiple reservoirs. It includes the study of land degradation and reservoir siltation processes

'10% of your medical students will cause 90% of your problems': a prospective correlational study

• Objectives Our aim was to explore the relationship between medical student Conscientiousness Index scores and indicators of later clinical performance held in the UK Medical Education Database. Objectives were to determine whether conscientiousness in first and second year medical students predicts later performance in medical school and in early practice. Policy implications would permit targeted remediation where necessary or aid in selection. • Design Prospective correlational study • Setting A single UK medical school and early years of practice, 2005-2018. • Participants Data were obtained from the UK Medical Education Database (UKMED) on 858 students. Full outcome data was available for variable numbers of participants, as described in the text. • Main outcome measures Scores on the UK Foundation Programme Office’s Situational Judgement Test (SJT) and Educational Performance Measure (EPM), the Prescribing Safety Assessment (PSA), and Annual Review of Competency Progression (ARCP) outcomes. • Results Linear regression analysis shows Conscientiousness Index scores significantly correlate with pre- and postgraduate performance variables,: SJT scores (R=0.373, R2=0.139, B=0.066, p<0.001, n=539); PSA scores (R=0.249, R2=0.062, B=0.343, p<0.001, n=462); EPM decile scores for the 1st (lowest) decile are significantly lower than the remaining 90% (P=0.003, n=539), as are PSA scores (p<0.001, n=463), and ARCP Year 2 scores (p=0.019, n=517). The Odds Ratio that students in the 1st decile fail to achieve the optimum ARCP outcome is 1.6126 (CI 1.1400 to 2.2809, p=0.0069, n=618). • Conclusions Conscientiousness Index scores in Year 1 and 2 of medical school have predictive value for later performance in knowledge, skills and clinical practice. This trait could be used either for selection, or for targeted remediation to avoid potential problems in the future

A study to investigate the effectiveness of SimMan® as an adjunct in teaching preclinical skills to medical students

Background: Following the GMC’s report on Tomorrow’s Doctors, greater emphasis has been placed on training in clinical skills, and the integration of clinical and basic sciences within the curriculum to promote the development of effective doctors. The use of simulation in the learning environment has the potential to support the development of clinical skills in preclinical medical students whilst in a ‘safe’ environment, but currently there is little evidence on its effectiveness. Methods: Seventy nine year one medical students were divided into two groups. A pre-test was conducted by both groups, after which one group performed chest examination on their peers whilst the other group examined the SimMan® manikin. Both groups subsequently performed a mid-test and crossed over so that the group that conducted peer examination examined the manikin and vice-versa. Finally a post-test was conducted. The students were scored for formative feedback whilst performing examinations. Students completed a feedback questionnaire at the end of the session. Data were analysed using a one-way ANOVA, independent t-test and 2- proportion Z test. Results: When the two groups were compared, there was no significant difference in their pre-test and post-test knowledge scores, whereas mid-test knowledge scores increased significantly (P < 0.001), with the group using SimMan® initially scoring higher. A significant increase in the test scores was seen in both groups after using SimMan® (P < 0.001). Students’ confidence increased significantly in differentiating between normal and abnormal signs (P < 0.001). Students highly valued the use of the manikin in the session with 96% of students reporting that it enhanced their learning experience. Conclusions: The study demonstrated a significant improvement in the students’ knowledge after examining the manikin and students also reported an increase in their confidence. Students’ feedback was generally very positive and they perceived the incorporation of manikin-based examinations useful to prepare them for future patient contact. The use of simulation in this context supports an integrated learning approach when used as an adjunct to peer examination, and can benefit the acquisition of clinical skills in preclinical medical students

Conscientious, competent and caring: producing the junior doctor of the future

This article is based on the Association for the Study of Medical Education Gold Medal Plenary for 2022, given by the first author. It outlines different ways in which medical training can be approached, based on his career and his work with colleagues. Among the attributes that it would be desirable to promote in future doctors are conscientiousness, competence and care for patients as individuals. This article explores each of these in separate sections. The first demonstrates that the trait of conscientiousness can be observed in first and second year medical students by their compliance in routine low level tasks such as attendance and submission of required work on time. A ‘conscientiousness index’ calculated on this basis is a statistically significant predictor of later events such as performance in exams, the prescribing safety assessment, and the UK situational judgement test in subsequent years, and also in postgraduate assessments such as Royal college exams and the annual reviews of competence progression. The second proposes that competence in tasks undertaken by junior doctors is better achieved by teaching on medical imaging, clinical skills and living anatomy than by cadaveric dissection. The final section argues that the incorporation of arts and humanities teaching into medical education is likely to lead to better understanding of the patient perspective in later practice

An Inexpensive Retrospective Standard Setting Method Based on Item Facilities

Background Standard setting is one of the most challenging aspects of assessment in high-stakes healthcare settings. The Angoff methodology is widely used, but poses a number of challenges, including conceptualisation of the just-passing candidate, and the time-cost of implementing the method. Cohen methodologies are inexpensive and rapid but rely on the performance of an individual candidate. A new method of standard setting, based on the entire cohort and every item, would be valuable. Methods We identified Borderline candidates by reviewing their performance across all assessments in an academic year. We plotted the item scores of the Borderline candidates in comparison with Facility for the whole cohort and fitted curves to the resulting distribution. Results It is observed that for any given Item, an equation of the form y ≈ C.eFx where y is the Facility of Borderline candidates on that Item, x is the observed Item Facility of the whole cohort, and C and F are constants, predicts the probable Facility for Borderline candidates over the test, in other words, the cut score for Borderline candidates. We describe ways of estimating C and F in any given circumstance, and suggest typical values arising from this particular study: that C = 12.3 and F = 0.021. Conclusions C and F are relatively stable, and that the equation y = 12.3.e0.021x can rapidly be applied to the item Facility for every item. The average value represents the cut score for the assessment as a whole. This represents a novel retrospective method based on test takers. Compared to the Cohen method which draws on one score and one candidate, this method draws on all items and candidates in a test. We propose that it can be used to standard set a whole test, or a particular item where the predicted Angoff score is very different from the observed Facility

Handbook of Research on the Relationship Between Autobiographical Memory and Photography

Over the past year colleagues from LCC and UAL's Experimental Pedagogies Research Group (EPRG), Dr Nela Milic (EPRG), Dr Paul Lowe, Dr Mark Ingham (EPRG), along with two UAL PhD alumni, Dr Vasileios Kantas and Dr Sara Andersdotter (EPRG) have editied the Handbook of Research on the Relationship Between Autobiographical Memory and Photography. This key volume of research has 27 chapters by leading practitioners in the fields of memory, photography, and autobiography. It includes chapters from Dr Jennifer Good and Sophy Rickett from LCC, with contributions from two LCC doctoral students, Elin Karlsson (EPRG and Mireia Ludevid Llop (EPRG). Other UAL colleagues who successfully submitted chapters were Natalie Payne from LCF and Tim Stephens (EPRG) from the Exchange. Description: Autobiographical memory and photography have been inextricably linked since the first photographs appeared during the 19th century. These links have often been described from each other's discipline in ways that often have led to misunderstandings about the complex relationships between them. The Handbook of Research on the Relationship Between Autobiographical Memory and Photography covers many aspects of the multiple relationships between autobiographical memory and photography such as the idea that memory and photography can be seen as forms of mental time travel and the effect photography has on autobiographical memory. Covering key topics such as identity, trauma, and remembrance, this major reference work is ideal for industry professionals, sociologists, psychologists, artists, researchers, scholars, academicians, practitioners, educators, and students

Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement

Background: Cardiac Rehabilitation (CR) is a recommendation in international clinical practice guidelines given its’ benefits, however use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrolment and adherence into implementable recommendations. Methods: The writing panel was constituted by representatives of societies internationally concerned with preventive cardiology, and included disciplines that would be implementing the recommendations. Patient partners served, as well as policy-makers. The statement was developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane review on interventions to promote patient utilization of CR. These were circulated to panel members, who were asked to rate each on a 7-point Likert scale in terms of scientific acceptability, actionability, and feasibility of assessment. A web call was convened to achieve consensus and confirm strength of the recommendations (based on GRADE). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrolment, healthcare providers, particularly nurses (strong), should promote CR to patients face-to-face (strong), and that to increase adherence part of CR could be delivered remotely (weak). Ratings for the 3 recommendations were 5.95±0.69 (mean ± standard deviation), 5.33±1.12 and 5.64±1.08, respectively. Conclusions: Interventions can significantly increase utilization of CR, and hence should be widely applied. We call upon cardiac care institutions to implement these strategies to augment CR utilization, and to ensure CR programs are adequately resourced to serve enrolling patients and support them to complete programs

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec