223 research outputs found
Moebius strip enterprises and expertise in the creative industries: new challenges for lifelong learning?
The paper argues that the emergence of a new mode of production â co-configuration is generating new modes of expertise that EU policies for lifelong learning are not designed to support professionals to develop. It maintains that this change can be seen most clearly when we analyse Small and Medium Size (SMEs) enterprises in the creative industries. Drawing on concepts from Political Economy - âMoebius strip enterprise/expertiseâ and Cultural Historical Activity Theory - project-objectâ and the âspace of reasonsâ, the paper highlights conceptually and through a case study of an SME in the creative industries what is distinctive about the new modes of expertise, before moving on to reconceptualise expertise and learning and to consider the implications of this reconceptualisation for EU policies for lifelong learning. The paper concludes that the new challenge for LLL is to support the development of new forms expertise that are difficult to credentialise, yet, are central to the wider European goal of realising a knowledge economy
Non-traumatic Arm, Neck, and Shoulder Complaints in General Practice: Incidence, Course and Management
Non-traumatic complaints of arm, neck, and shoulder are common and can result in functional limitations in daily life and may sometimes lead to sickness absence. Reported symptoms are e.g. pain, tingling, stiffness, numbness, loss of hand coordination. When seeking medical care for these complaints, the general practitioner (GP) is usually the first person to consult. This thesis studies patients who consult their GP with a new non-traumatic complaint of arm, neck or shoulder, with a focus on incidence, course and management.
The incidence study showed that a fulltime GP is consulted about 3 times every week for a new non-traumatic complaint of arm, neck, or shoulder, most frequently located at neck or shoulder.
Six months after the first consultation with their GP, 46% of the patients in the cohort study reported no recovery. Next to several complaint specific variables, the psychosocial variables little social support and high score on somatization were predicitve of non-recovery at 6 months.
Management upto 6 months after the first consultation most frequently consisted of prescribed analgesics and referral for physiotherapy. Specific and non-specific diagnostic subgroups differed in the frequency that corticosteroid injections were applied, and referrals to physiotherapy and to a medical specialist.
In addition variables associated with five common management options within a few weeks after the first consultation were evaluated. Overall, besides diagnosis, most frequently long duration of complaints, more functional limitations but also several GP characteristics were associated with the application of a treatment option in non-traumatic arm, neck and shoulder complaints
Work Experience and VET: Insights from the Connective Typology and the Recontextualisation Model
The chapter compares two models of work experience â connective typology of work experience and recontextualisation of knowledge model â and uses the term work experience to refer to the way that young people enrolled in both school- and apprenticeship-based VET learn to relate their experience of education as represented by the acquisition of domain knowledge and their experience of work as represented by occupational values, skill and knowledge to one another. The common link between the two models is that they accept the existence of a mediated relationship between education and work. The former explores this relationship from a boundary-crossing perspective, focusing on learnersâ movement between education and work, and identifies the outcomes associated with different models of work experience. The latter focuses on the interplay between the manifestation of knowledge in the contexts of education and work and learnersâ movement within and between both contexts. It differs from the connective typology, because it takes account of the mediated nature of the contexts of education and work as well as the process of learning through work experience. The chapter concludes by using the concept of recontextualisation to highlight how digital and mobile technologies could serve as resources to facilitate learning through work experience in school- and apprenticeship-based VET
Thermal relaxation of magnetic clusters in amorphous Hf_{57}Fe_{43} alloy
The magnetization processes in binary magnetic/nonmagnetic amorphous alloy
Hf_{57}Fe_{43} are investigated by the detailed measurements of magnetic
hysteresis loops, temperature dependence of magnetization, relaxation of
magnetization and magnetic ac susceptibility, including a nonlinear term.
Blocking of magnetic moments at lower temperatures is accompanied with the slow
relaxation of magnetization and magnetic hysteresis loops. All of the observed
properties are explained with the superparamagnetic behaviour of the single
domain magnetic clusters inside the nonmagnetic host, their blocking by the
anisotropy barriers and thermal fluctuation over the barriers accompanied by
relaxation of magnetization. From magnetic viscosity analysis based on thermal
relaxation over the anisotropy barriers it is found out that magnetic clusters
occupy the characteristic volume from 25 up to 200 nm3 . The validity of the
superparamagnetic model of Hf_{57}Fe_{43} is based on the concentration of iron
in the Hf_{100-x}Fe_{43} system that is just below the threshold for the long
range magnetic ordering. This work throws more light on magnetic behaviour of
other amorphous alloys, too
The contribution of diet and genotype to iron status in women:a classical twin study
This is the first published report examining the combined effect of diet and genotype on body iron content using a classical twin study design. The aim of this study was to determine the relative contribution of genetic and environmental factors in determining iron status. The population was comprised of 200 BMI- and age-matched pairs of MZ and DZ healthy twins, characterised for habitual diet and 15 iron-related candidate genetic markers. Variance components analysis demonstrated that the heritability of serum ferritin (SF) and soluble transferrin receptor was 44% and 54% respectively. Measured single nucleotide polymorphisms explained 5% and selected dietary factors 6% of the variance in iron status; there was a negative association between calcium intake and body iron (pâ=â0.02) and SF (pâ=â0.04)
On the making and taking of professionalism in the further education workplace
This paper examines the changing nature of professional practice in English further education. At a time when neo-liberal reform has significantly impacted on this under-researched and over-market-tested sector, little is known about who its practitioners are and how they construct meaning in their work. Sociological interest in the field has tended to focus on further education practitioners as either the subjects of market and managerial reform or as creative agents operating within the contradictions of audit and inspection cultures. In challenging such dualism, which is reflective of wider sociological thinking, the paper examines the ways in which agency and structure combine to produce a more transformative conception of the further education professional. The approach contrasts with a prevailing policy discourse that seeks to re-professionalise and modernise further education practice without interrogating either the terms of its professionalism or the neo-liberal practices in which it resides
A guideline for the outpatient management of glycaemic control in people with cancer
Individuals with cancer are at increased risk of developing new onset diabetes mellitus and hyperglycaemia, and an estimated 20% of people with cancer already have an underlying diagnosis of diabetes mellitus.
People with both cancer and diabetes may have an increased risk of toxicities, hospital admissions and morbidity, with hyperglycaemia potentially attenuating the efficacy of chemotherapy often secondary to dose reductions and early cessation. Numerous studies have demonstrated that hyperglycaemia is prognostic of worse overall survival and risk of cancer recurrence.
These guidelines aim to provide the oncology/haemato-oncology and diabetes multidisciplinary teams with the tools to manage people with diabetes commencing anti-cancer/ glucocorticoid therapy, as well as identifying individuals without a known diagnosis of diabetes who are at risk of developing hyperglycaemia and new onset diabetes
Comfort radicalism and NEETs: a conservative praxis
Young people who are not in education, employment or training (NEET) are construed by policy makers as a pressing problem about which something should be done. Such young people's lack of employment is thought to pose difficulties for wider society in relation to social cohesion and inclusion and it is feared that they will become a 'lost generation'. This paper(1) draws upon English research, seeking to historicise the debate whilst acknowledging that these issues have a much wider purchase. The notion of NEETs rests alongside longstanding concerns of the English state and middle classes, addressing unruly male working class youth as well as the moral turpitude of working class girls. Waged labour and domesticity are seen as a means to integrate such groups into society thereby generating social cohesion. The paper places the debate within it socio-economic context and draws on theorisations of cognitive capitalism, Italian workerism, as well as emerging theories of antiwork to analyse these. It concludes by arguing that âradicalâ approaches to NEETs that point towards inequities embedded in the social structure and call for social democratic solutions veer towards a form of comfort radicalism. Such approaches leave in place the dominance of capitalist relations as well as productivist orientations that celebrate waged labour
Rethinking the learning space at work and beyond: The achievement of agency across the boundaries of work-related spaces and environments
This paper focuses on the notion of the learning space at work and discusses the extent to which its different configurations allow employees to exercise personal agency within a range of learning spaces. Although the learning space at work is already the subject of extensive research, the continuous development of the learning society and the development of new types of working spaces calls for further research to advance our knowledge and understanding of the ways that individuals exercise agency and learn in the workplace. Research findings suggest that the current perception of workplace learning is strongly related to the notion of the learning space, in which individuals and teams work, learn and develop their skills. The perception of the workplace as a site only for work-specific training is gradually changing, as workplaces are now acknowledged as sites for learning in various configurations, and as contributing to the personal development and social engagement of employees. This paper argues that personal agency is constructed in the workplace, and this process involves active interrelations between agency and three dimensions of the workplace (individual, spatial and organisational), identified through both empirical and theoretical research. The discussion is supported by data from two research projects on workplace learning in the United Kingdom. This paper thus considers how different configurations of the learning space and the boundaries between a range of work-related spaces facilitate the achievement of personal agency
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PS1424 The CRAB score: a simple prognostic tool in multiple myeloma
Background:
Current prognostic scoring systems in multiple myeloma lack consensus and are often clinically impractical. The key diagnostic features known as CRAB; hypercalcaemia (C), renal impairment (R), anaemia (A), and bone lesions (B), are known to represent end organ damage in myeloma.
Aims:
We aimed to produce a simplified and practical prognostic tool for use in multiple myeloma patients as an alternative to current practice, therefore enabling prognostic guidance to be distributed to a wider group of patients. Since the laboratory tests required to calculate CRAB score are routinely undertaken in clinical practice, we proposed a method of predicting outcome based on these results alone, which has not yet been reported.
Methods:
We examined a combined database of clinical and survival information for 314 patients from Brighton and Worthing, Sussex, UK, over a 6 year period, who were newly diagnosed with myeloma, and represent real-world clinical experience. To determine the presence of a CRAB feature, the cut-off values previously defined by the International Myeloma Working Group (IMWG) were used; serum calcium >2·75 mmol/L, serum creatinine >177 Όmol/L, haemoglobin 20 g/L below lower limit of normal), and one or more osteolytic lesion on skeletal radiography, CT, PET-CT or MRI.
Patients were stratified into five CRAB score groups by having either 0, 1, 2, 3 or 4 CRAB features at initial presentation, with a score of 0 denoting a diagnosis of smouldering myeloma. We then studied the relationship between CRAB score and overall survival using Kaplan Meier curves plotted by the statistics programme SPSS.
Results:
Our analysis reveals that each additional CRAB feature confers a stepwise statistically significant poorer outcome in terms of overall survival as shown in Figure 1a. This result was regardless of the treatment regimen the patient received and gave 5-year survival percentages of 81%, 58%, 41%, 22% and 0% for patients with CRAB scores 0â4 respectively. We also found CRAB score to have coherence with the current International Staging System (ISS) scoring system, which combines serum albumin as a measure of general patient health with ÎČ2-microglobulin as a measure of tumour bulk to estimate risk.
Cytogenetic data required for the revised ISS score was not undertaken for the majority of patients, highlighting the lack of feasibility of this system in practice, although we did observe higher CRAB scores for those patients identified with poor risk chromosomal abnormalities. A trend for higher ISS score with higher CRAB score was observed, further validating the CRAB scoring system (figure 1b).
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Summary/Conclusion:
Our study shows that the CRAB score yields accurate prognostic predictions for patients with newly diagnosed multiple myeloma based on simple clinical criteria. It has more prognostic categories than the currently used ISS score (5 versus 3) and superior clinical utility than expensive and time-consuming cytogenetic-based scoring systems that have been recently described. These results indicate that the CRAB score may provide a useful and reliable tool to guide prognostic evaluation in newly diagnosed myeloma patients, requiring only routine laboratory testing to be undertaken, and therefore greater availability to patients in diverse clinical settings
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