Dynamic confidence during simulated clinical tasks

Objective: Doctors' confidence in their actions is important for clinical performance. While static confidence has been widely studied, no study has examined how confidence changes dynamically during clinical tasks. Method: The confidence of novice (n = 10) and experienced (n = 10) trainee anaesthetists was measured during two simulated anaesthetic crises, bradycardia (easy task) and failure to ventilate (difficult task). Results: As expected, confidence was high in the novice and experienced groups in the easy task. What was surprising, however, was that confidence during the difficult task decreased for both groups, despite appropriate performance. Conclusions: Given that confidence affects performance, it is alarming that doctors who may be acting unsupervised should lose dynamic confidence so quickly. Training is needed to ensure that confidence does not decrease inappropriately during a correctly performed procedure. Whether time on task interacts with incorrect performance to produce further deficits in confidence should now be investigated

Measuring Symbol and Icon Characteristics: Norms for Concreteness, Complexity, Meaningfulness, Familiarity, and Semantic Distance for 239 Symbols

This paper provides rating norms for a set of symbols and icons selected from a wide variety of sources. These ratings enable the effects of symbol characteristics on user performance to be systematically investigated. The symbol characteristics that have been quantified are considered to be of central relevance to symbol usability research and include concreteness, complexity, meaningfulness, familiarity, and semantic distance. The interrelationships between each of these dimensions is examined and the importance of using normative ratings for experimental research is discussed

Eyelid development, fusion and subsequent reopening in the mouse

The process of eyelid development was studied in the mouse. The critical events occur between about 15.5 d postcoitum (p.c.) and 12 d after birth, and were studied by conventional histology and by scanning electron microscopy. At about 15.5 d p.c. the cornea of the eye is clearly visible with the primitive eyelids being represented by protruding ridges of epithelium at its periphery. Over the next 24 h, eyelid development proceeds to the stage when the cornea is completely covered by the fused eyelids. Periderm cells stream in to fill the gap between the developing eyelids. Their proliferative activity is such that they produce a cellular excrescence on the outer surface of the line of fusion of the eyelids. This excrescence had almost disappeared by about 17.5 d p.c. Keratinisation is first evident at this stage on the surface of the eyelids and passes continuously from one eyelid to the other. Evidence of epidermal differentiation is more clearly seen in the newborn, where a distinctive stratum granulosum now occupies about one third of its entire thickness. Within the subjacent dermis, hair follicles are differentiating. By about 5 d after birth, a thick layer of keratin extends without interruption across the junctional region. While a noticeable surface indentation overlies the latter, a similar depression is only seen on the conjunctival surface by about 10 d after birth. Keratinisation is also observed to extend in from the epidermal surface to involve the entire region between the 2 eyelids at about this time.(ABSTRACT TRUNCATED AT 250 WORDS

On Ptolemaic metric simplicial complexes

We show that under certain mild conditions, a metric simplicial complex which satisfies the Ptolemy inequality is a CAT(0) space. Ptolemy's inequality is closely related to inversions of metric spaces. For a large class of metric simplicial complexes, we characterize those which are isometric to Euclidean space in terms of metric inversions.Comment: 13 page

Starting the journey towards manufacturing excellence : MX Start. Innovation report

Manufacturing matters. It matters because of the economic contribution it provides in terms of wealth generation, employment and exports. The manufacturing industry in the United Kingdom can be strengthened. The opportunity for improvement includes closing the productivity gap between other countries, encouraging innovation and developing the skills of the workforce, in order to be globally competitive, drive growth and to help reduce the trade deficit. Critical to exploiting these opportunities, and to the success of the industry, is the adoption of best practice. Existing support for manufacturing improvement can be costly, difficult to access or dependent on input from external experts. This support therefore is not readily accessible to every manufacturing company. There are also a number of quality and performance awards available, however these are predominantly focused on recognising success rather than on how this success can be attained. This research fulfils the gap by providing widely accessible support for manufacturing companies that is focused on helping them to improve. The support provided helps companies to identify and adopt relevant best practices. This research work adapted a product evaluation framework to develop MX Start, a process that supports manufacturing companies to start their improvement journey towards manufacturing excellence. MX Start was developed following a review of the definition of Manufacturing Excellence, a needs assessment of the opportunity, analysis of best practice dissemination strategies, comparative analysis of existing tools and a review of effective self assessment and feedback principles. MX Start provides an easy to use, free of charge, web based system that facilitates manufacturing companies to start their excellence journey. It enables manufacturers to benchmark themselves against best practice in order to gain a greater understanding of what excellence entails, and to enable improvement areas to be identified. This is then supported with a report that helps companies to prioritise the improvement opportunities and provides feedback to then help them make these improvements. The combination of the free of charge, widely accessible, self-directed system that is solely concerned with supporting and encouraging companies to improve, is the basis of the innovation of this work. MX Start has demonstrated impact to the manufacturing industry through a pilot and on-going work with the Manufacturing Advisory Service (MAS). As part of the pilot, over two hundred companies used the process to conduct diagnostic activities to define areas for improvement, and identify where and how they could implement best practices. As a result, MAS in the West Midlands have adopted the tool and supported further developments of this research. This has increased the opportunity for MX Start to help companies progress on their excellence journey and therefore, help support the manufacturing industry to improve. An evaluation of MX Start by companies and manufacturing experts, found that the tool was easy to understand and use, and that it helped companies to identify, and be motivated, to make improvements. The web based system lends itself to further development. In addition to the assessment and report elements of MX Start, the website contains a resource library. The resources contain more information and guidance. The opportunity for the future is to expand this library and build a comprehensive database of support. This would increase the ability of MX Start to support manufacturers to exploit the improvement opportunities to strengthen the competitiveness of the manufacturing industry

Progressing in Tandem: A Sure Start Initiative for Enhancing the Role of Parents in Children's Early Education

The Tandem Project is an educational programme, targeting preschoolers, sponsored by the DfEE Sure Start initiative. It aims to encourage parents from low SES bacgrounds to take a greater role in preparing their children for school. Parents are given a series of games to play with their children designed to develop basic pre-reading and numerical skills. Pre-reading games include listening to stories, learning about the representational qualities of print, reciting nursery rhymes, recognising and discriminating shapes and letters and analysing the sound of words. Numerical games include learning about length, size and quantity, linking concepts about quantity with the number systems, counting and recognising written numerals. A preliminary study found the programme was successful in developing children's skills although outcomes were moderated by family socio-economic status. The implications for involving parents in the education of their preschool children are discussed

Boundary effect of a partition in a quantum well

The paper wishes to demonstrate that, in quantum systems with boundaries, different boundary conditions can lead to remarkably different physical behaviour. Our seemingly innocent setting is a one dimensional potential well that is divided into two halves by a thin separating wall. The two half wells are populated by the same type and number of particles and are kept at the same temperature. The only difference is in the boundary condition imposed at the two sides of the separating wall, which is the Dirichlet condition from the left and the Neumann condition from the right. The resulting different energy spectra cause a difference in the quantum statistically emerging pressure on the two sides. The net force acting on the separating wall proves to be nonzero at any temperature and, after a weak decrease in the low temperature domain, to increase and diverge with a square-root-of-temperature asymptotics for high temperatures. These observations hold for both bosonic and fermionic type particles, but with quantitative differences. We work out several analytic approximations to explain these differences and the various aspects of the found unexpectedly complex picture.Comment: LaTeX (with iopart.cls, iopart10.clo and iopart12.clo), 28 pages, 17 figure

Ultrafast harmonic mode-locking of monolithic compound-cavity laser diodes incorporating photonic-bandgap reflectors

We present the first demonstration of reproducible harmonic mode-locked operation from a novel design of monolithic semiconductor laser comprising a compound cavity formed by a 1-D photonic-bandgap (PBG) mirror. Mode-locking (ML) is achieved at a harmonic of the fundamental round-trip frequency with pulse repetition rates from 131 GHz up to a record high frequency of 2.1 THz. The devices are fabricated from GaAs-Al-GaAs material emitting at a wavelength of 860 nm and incorporate two gain sections with an etched PBG reflector between them, and a saturable absorber section. Autocorrelation studies are reported which allow the device behavior for different ML frequencies, compound cavity ratios, and type and number of intra-cavity reflectors to be analyzed. The highly reflective PBG microstructures are shown to be essential for subharmonic-free ML operation of the high-frequency devices. We have also demonstrated that the single PBG reflector can be replaced by two separate features with lower optical loss. These lasers may find applications in terahertz; imaging, medicine, ultrafast optical links, and atmospheric sensing