The commodification of higher education in the welfare state of Sweden: exploring the possibilities

For about three decades now the world’s economic systems have mainly embraced a neoliberal paradigm. The precept of this paradigm is, more egocentric than the capitalist philosophy of homo economicus, that it is not enough to have the market determine all human or institutional relations, but that there should be nothing which is not the market. Neoliberalism would see surrendered to the market to be commodified all the services communally provided for its citizens by the state, such as healthcare and education. Neoliberalism and its many approaches mount formidable pressure on states to fall to its sway. The environment created by neoliberalism is a challenge to states, like Sweden, that still believe in the central provision of essential social services so that the enjoyment of such services would not depend on the economic status of the individual citizen, because in the long run the state would benefit from having it so. This research studied, given this environment, whether the provision of higher education in the welfare state of Sweden could be commodified. An extensive review of relevant literature was done to define the problem and establish a theoretical frame. From there a questionnaire was designed and administered to Swedish universities. The responses were used to formulate questions for semi-structured interviews with parliamentarians and university vice-chancellors. The research found, among other things, a transformation from an inward-looking system to one of increasing globalisation; from detailed state planning and control to a broad degree of freedoms to act. There is a lack of desire for universities to be fully independent of the state; a desire for broadened entrepreneurialism, especially in the areas of conversion of research results into products and co-operation with the private sector. There are statutes that hinder some entrepreneurial activities or limit the universities’ ability to make money from them; a vehement stand against the commodification of higher education for natives, but qualified openness for some categories of foreign students paying for their education in the country. There is diminished solidarity-thinking and the use of global educational contacts as a means to support the country’s export sector. There is no indication that the possibility exists in the foreseeable future for higher education in Sweden to move from the sphere of public good to private good since an overwhelming majority of those most closely associated with legislation, policy formulation and execution are against the commodification of higher education

Characterization of the Mechanical and Microstructural Properties of Thin Non-Orientated Electrical Steel Sheets

With the rise and growth of electric vehicles, enhancing the design and implementation of electric engines in transportation vehicles is essential. Electric motors are an essential part of this enhancement. The material from which the stator and rotor cores of electric motors are made out of are required to be highly permeable with low magnetic losses and magnetostriction. Non-Oriented Electrical steel is a cost-effective choice of material that meets these requirements. In this thesis, three grades of non-oriented electrical steel sheets namely: 27PNX1350F, 25SW1250 and 20SW1200 with sheet thicknesses of 0.27mm, 0.25mm and 0.20mm respectively were categorized mechanically and microstructurally at room and an elevated temperature of 150°C. The initial microstructure of the non-oriented electrical steel sheets was first categorized to confirm its chemical composition, present phases and texture. Then, quasi-static tensile tests at both temperatures were run after which the data was analyzed and the tensile properties were extracted and modeled. Then, fractured surfaces of the samples were examined under a scanning electron microscope to investigate the failure mechanisms under the tensile loading condition. After the complete characterization of the tensile properties, cyclic tests at both temperatures were run after which the data was analyzed and the fatigue properties were extracted and modeled. The failure mechanisms under cyclic loading were also investigated using scanning electron microscopy. The sheets were confirmed to contain 3% silicon content with ferritic iron present. The steel sheets were also confirmed to have a body centered cubic crystal structure as well as a random grain orientation and texture. The tensile properties at room temperature and 150° C were calculated as well as modeled using the Ramberg-Osgood equation. The obtained elastic modulus for all three grades of non-oriented electrical steel sheets were found to be below the typically expected properties of structural steel but well within the range of electrical steels found in literature. The tensile properties along the rolling direction, transverse direction and 45° orientation were studied and similar results were obtained for the rolling and transverse directions while the results along the 45° orientation were noticeably different. The fracture surface revealed a mixture of ductile and brittle failure fracture mechanisms. A comparison between the three grades of non-oriented steel sheets and a comparison between the tensile properties at room temperature and 150°C was presented. It was found that the three grades of non-oriented electrical steel sheets had comparable tensile properties and there was no conclusive evidence that the sheet thickness had any effect on the tensile properties. It was also found that the increase in temperature had an adverse effect on the tensile properties of the steel sheets which was more significant in the yield strength and elongation. The fatigue properties at room temperature and 150° C were also examined as well as modeled using the Basquin equation. In addition, design curves with reliability and confidence levels of 90% were obtained using the Owen's tolerance method. The fracture surface revealed a mixture of cyclic deformation and brittle failure fracture mechanisms. A comparison between the fatigue properties of the three grades was presented. Comparable lives at the similar stress amplitudes were observed and with this observation, the conclusion that the sheet thickness did not have an effect on the fatigue life was reached. The effect of mean stress, temperature and cutting method on the fatigue life of non-oriented steel sheets were also investigated and presented. Similar to the tensile properties, increasing the temperature also had an adverse effect on the fatigue life by yielding lower lives at the same stress amplitudes at the elevated temperature. Extra tests performed at different load ratios showed that increasing the mean stress did not significantly affect the life at the same stress amplitudes but lowered the expected endurance strength of the material. Finally, the fatigue life of specimens cut with water-jet and CNC machining were compared. It was found that water-jet cutting deteriorates the edge roughness of the specimens which in turn adversely affects the fatigue life significantly

Nerves and blood vessels in degenerated intervertebral discs are confined to physically disrupted tissue

Nerves and blood vessels are found in the peripheral annulus and endplates of healthy adult intervertebral discs. Degenerative changes can allow these vessels to grow inwards and become associated with discogenic pain, but it is not yet clear how far, and why, they grow in. Previously we have shown that physical disruption of the disc matrix, which is a defining feature of disc degeneration, creates free surfaces which lose proteoglycans and water, and so become physically and chemically conducive to cell migration. We now hypothesise that blood vessels and nerves in degenerated discs are confined to such disrupted tissue. Whole lumbar discs were obtained from 40 patients (aged 37–75 years) undergoing surgery for disc herniation, disc degeneration with spondylolisthesis or adolescent scoliosis (‘non‐degenerated’ controls). Thin (5‐μm) sections were stained with H&E and toluidine blue for semi‐quantitative assessment of blood vessels, fissures and proteoglycan loss. Ten thick (30‐μm) frozen sections from each disc were immunostained for CD31 (an endothelial cell marker), PGP 9.5 and Substance P (general and nociceptive nerve markers, respectively) and examined by confocal microscopy. Volocity image analysis software was used to calculate the cross‐sectional area of each labelled structure, and its distance from the nearest free surface (disc periphery or internal fissure). Results showed that nerves and blood vessels were confined to proteoglycan‐depleted regions of disrupted annulus. The maximum distance of any blood vessel or nerve from the nearest free surface was 888 and 247 μm, respectively. Blood vessels were greater in number, grew deeper, and occupied more area than nerves. The density of labelled blood vessels and nerves increased significantly with Pfirrmann grade of disc degeneration and with local proteoglycan loss. Analysing multiple thick sections with fluorescent markers on a confocal microscope allows reliable detection of thin filamentous structures, even within a dense matrix. We conclude that, in degenerated and herniated discs, blood vessels and nerves are confined to proteoglycan‐depleted regions of disrupted tissue, especially within annulus fissures

Administrators in higher education: organizational expansion in a transforming institution

Recent European research has revealed growth in the number of administrators and professionals across different sections of universities—a long established trend in US universities. We build on this research by investigating the factors associated with variation in the proportion of administrators across 761 Higher Education Institutions (HEIs) in 11 European countries. We argue that the enactment of expanded and diversified missions of HE is one of the main factors nurturing universities’ profesional and administrative bodies. Our findings support such an assertion; regardless of geographical and institutional differences, HEIs with high levels of “entrepreneurialism” (e.g. in service provision and external engagement) are characterized by a larger proportion of administrative staff. However, we find no empirical support for arguments citing structural pressures and demands on HEIs due to higher student enrolments, budget cuts or deregulation as engines driving such change. Instead, our results point towards, as argued by neo-institutionalists, the diffusion of formal organization as a model of institutional identity and purpose, which is especially prevalent at high levels of external connectedness

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

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care