bluuebunny/crossref_metadata_2025 huggingface dataset:
Why it’s Worth Going to University
Authors: Willetts David
Published: November 2020

You may well have gone to university. If so, would you do it all over again? I expect so. One survey of recent graduates found 96 per cent of them would do it again. If you haven’t gone but are thinking about going to university you should almost certainly go for it. You won’t regret it. It may well turn out to be one of the most rewarding and transforming experiences of your life. But what is it that makes more and more of us go to university when the media are full of stories of graduates who are unemployed and the usual clichés that too many people go to university? And why are record numbers of young people going even after the changes in student finance, which I helped to bring in, mean that graduates are likely to be paying back more over their working lives? Just look at the newspaper headlines: . . . Thousands of new graduates out of work, figures show. Expansion of the university sector has destroyed its status. UK graduates are wasting degrees in lower-skilled jobs. Today’s university students are being sold a lie. . . . Is College Worth It? is a very fair question, and the American book with that title answers with a clear ‘No’ for many people, many courses, and many institutions. The conventional wisdom is that going to university is often an expensive waste of time. But for most students the truth is the opposite. For most young people it is a deeply rewarding, life-changing experience. And it matters particularly if you come from a poor background because then it really could transform your chances in life. I meet parents who think that too many people go to university but definitely want their own child to go—it is the other parents’ kids who aren’t supposed to go. But the other parents might not see it that way. A survey of mothers of children born in the year 2000 showed that even for the mothers with the lowest qualifications 96 per cent wanted their child to go to university.
Where: Globalization
Authors: Willetts David
Published: November 2020

‘High, high above the North Pole, on the first day of 1969, two professors of English Literature approached each other at a combined velocity of 1200 miles per hour.’ That vivid opening to David Lodge’s Changing Places captures how globalization has reached the modern university. We saw in Chapter Four that only 28 per cent of British academics are defined as ‘sedentary’ having never worked abroad. 50 per cent have worked abroad for up to two years. The rest have migrated, moving away for more than two years or coming back after such a long stay abroad. We have fewer sedentary academics than any comparable country, apart from Canada which has an open border with the US. Thirty-six per cent of German researchers are sedentary—and 52 per cent of Italians. Half of research papers by British academics are now co-authored with someone overseas and they are more likely to be cited. David Lodge’s two professors were travelling back to the future: in the Middle Ages Europe’s universities formed a highly integrated international system. The structure of the medieval disciplines was the same across Europe and so were the key texts. There was a common language of scholarship—Latin. Degrees were recognized across Christendom, entitling a teacher to teach anywhere (the ‘Licentiate ubique docendi’). Scholars and students such as Thomas Aquinas or Erasmus moved between Rome, Paris, and Cologne. Now Europe’s Bologna and Erasmus programmes are gradually re-creating levels of integration which our universities achieved in the Middle Ages: we must hope that Brexit does not cut Britain off from this. The Bologna process is not an EU programme: it is an intergovernmental declaration agreed in 1999 which sets a common structure of university study to make it easy for students to move between European countries. Heavily influenced by the English model, it specifies that a Bachelor’s degree takes 3–4 years, a Master’s degree 1–2 years, and a doctorate 3–4 years. Erasmus, by contrast, is the EU programme for promoting student and academic exchanges. It has proved particularly fruitful: over a million babies have now been born to students who met a partner from a different EU country as a result of the Erasmus programme.
Conclusion
Authors: Willetts David
Published: November 2020

Universities are important, sophisticated institutions but they are not well understood even by academics themselves who are busy researching gravitational waves or the rise of populism. They may, very reasonably, find their discipline much more interesting than their institution. Instead the campus novel, from Kingsley Amis’s Lucky Jim to Malcolm Bradbury’s The History Man, David Lodge’s Brummidge, and Howard Jacobson’s Sefton Goldberg, is the main way people working in universities investigate what they are like and communicate it to the wider world. But they can’t tell the whole story. There are also academics in British universities researching universities but not many of them— most of the books about the university are American. Meanwhile crude conspiracy theories claim to explain what is happening to a complex institution. One such narrative is ‘the university is under attack from managers/ministers/ markets threatening my/your/all disciplines’. Another narrative is ‘Universities are ivory towers: there are too many of them and too many people go.’ That is why I have tried to convey what I have learnt from my university education over the past decade and assembled the evidence to explain why both of those narratives are wrong. Such is my respect for the values of academia that, even if one might suspect this is just a heavily disguised ministerial memoir, it is at least the first example which has been subject to academic peer review. The behaviour of our universities is influenced by their environment and the incentives they face. That environment is very unusual and took its modern form as a result of a series of haphazard decisions taken in the late 1950s and early 1960s. Competitive nationwide entry gives our universities exceptional power to decide who they admit. That in turn has driven an intense educational arms race in our secondary schools which in turn has led to very early subject specialization. The behaviour of schools is shaped by the competition to get into the ‘best’ universities. However, we have seen that there are different types of universities, each well adapted to a distinctive role.
Management of pain and anxiety
Authors: Hosey M T , Roberts G J
Published: November 2020

Pain and anxiety are natural physiological and psychological responses. Pain is a direct response to an adverse stimulus that has occurred; anxiety is the unpleasant feeling, the worry that something unpleasant might occur. Pain and anxiety are often intertwined, especially in the dental setting. The best way to manage child dental anxiety is to avoid its occurrence in the first place through prevention of dental disease, good behaviour management, pain-free operative care, and treatment planning that is tailored to the needs and developmental stage of each individual child. These issues are detailed in the previous chapters. This Chapter specifically focuses on pharmacological pain and anxiety control and explores the roles of conscious sedation and general anaesthesia (GA) as adjuncts to behaviour management. A child’s perception of pain is subjective and varies widely, particularly with age. Infants up to about 2 years of age are believed to be unable to distinguish between pressure and pain. Older children begin to have some understanding of ‘hurt’ and begin to distinguish it from pressure or ‘a heavy push’. It is not always possible to identify which children are amenable to explanation and will respond by being cooperative when challenged with local anaesthesia (LA) and dental treatment in the form of drilling or extractions. Children over 10 years of age are much more likely to be able to think abstractly and participate more actively in the decision to use LA, sedation, or GA. As children enter their teenage years they are rapidly becoming more and more like adults and are able to determine more directly, sometimes emphatically, whether or not a particular method of pain control will be used. The response is further determined by the child’s coping ability influenced by family values, level of general anxiety and intelligence. There is a strong relationship between the perception of pain experienced and the degree of anxiety perceived by the patient. Painful procedures cause fear and anxiety; fear and anxiety intensify pain. This circle of cause and effect is central to the management of all patients. Good behaviour management reduces anxiety, which in turn reduces the perceived intensity of pain, which further reduces the experience of anxiety.
Introduction—Minoan Built Environment: Past Studies, Recent Perspectives, and Future Challenges
Authors: Letesson Quentin , Knappett Carl
Published: November 2020

Architecture and urbanism have been of constant interest to Minoan archaeologists since the beginning of the twentieth century. While there is some scholarly bias to this, with the field deeply affected by Sir Arthur Evans’s focus on the monumental architecture of Knossos, Minoan Crete continues to yield abundant evidence for a substantial built environment. Focusing on urban and architectural remains creates a strong bias in favour of one block of time, the Neopalatial period, which produced the largest amount of wellpreserved settlements and buildings. Yet, in general, the evidence we now have on the Minoan built environment is an undeniable resource, one that continues to grow thanks to ongoing studies of pre-existing remains as well as new excavation and survey projects. As is clear in Evans’s magnum opus, The Palace of Minos at Knossos, the large-scale excavations typical of the dawn of the last century were heavily directed towards the urban cores of the largest Minoan sites (e.g. Boyd Hawes et al. 1908; Hutchinson 1950). The bulk of what we know about the Minoan built environment comes from the first half of the twentieth century, initially through the intensive work of the foreign schools at Malia, Phaistos, Palaikastro, Gournia, Mochlos, and Pseira, later joined by countless excavations by Greek archaeologists. Yet, synthetic treatments really only began with the work of James Walter Graham, in the form of numerous papers published in the American Journal of Archaeology (see Letesson 2009 for a detailed review), and especially his Palaces of Crete (Graham 1962). Nonetheless, his comparative analyses, which also dealt with non-palatial buildings, were largely focused on polite architecture. With a particular interest in form and function, he built on Evans’s insights to be the first to identify, across a large sample of buildings, recurring architectural patterns in the Minoan built environment (e.g. Piano Nobile, residential quarters, banquet halls). His studies also included an innovative quantitative component, emphasizing the existence of a unit of length that builders would have used to lay out the palaces and some of the so-called ‘villas’.
Introduction: Archaeologies of Cremation
Authors: Williams Howard , Cerezo-Román Jessica I.
Published: November 2020

Four dramatic funerals punctuate the tenth- or eleventh-century Anglo-Saxon poem Beowulf; two involve the burning of the dead. While a Christian work to its core, the poem draws upon far older stories and at its very conclusion the poet provides a striking vision of an early medieval open-air cremation ceremony. Having died by the fire and poisonous bite of a dragon dwelling in a stone mound, the king of the Geats is cremated with treasures: helmets, swords, and coats of mail (Owen-Crocker 2000: 89). Before the raising of a burial mound upon a headland overlooking the sea, Beowulf ’s cremation is a focus of more than personal loss by mourners. Burning his body and then raising a mound containing the dragon-guarded treasure marks the end of the king’s protection for his people and foreshadows their own doom. As such, the cremation constitutes the scorching and fragmentation of body and things with fire. Cremation is a memorable spectacle created at a prominent location between land and sea, between earth and Heaven. The burning is also an emotional outpouring: grief and fire are intermingled (Owen-Crocker 2000: 91). Furthermore, as the culmination of the hero’s life and the poem, the burning is the lynchpin between the poetic past and the poet’s present and manifest in an ancient landscape populated with prominent earthen and stone monuments (Williams 2015a). The hero’s cremation in Beowulf is thus heroic, performative, emotive, and apocalyptic: linked to the changing of the world, times past, mourning, and the creation of memory. This description might seem diametrically opposed to the experience of cremation in Europe, North America, and elsewhere in the world today. Cremation as a widespread modern means of disposing of the dead is a process of technological transformation which is usually concealed from mourners. Moreover, the dual process of cremation means that burning the body is followed by the machine-grinding of the bones in a ‘cremulator’, reducing the ashes still further to grains of comparable size and shape (McKinley 1994a). In the poem, we find cremation as public, spectacular, and ritualized; today, it might be caricatured as secular and secretive. However, this contrast between early medieval poetry and modern practice is a false one.
Cremation and the Use of Fire in Mesolithic Mortuary Practices in North-West Europe
Authors: Jones Amy Gray
Published: November 2020

Cremation is not widely recognized as a form of mortuary treatment amongst the hunter-gatherer communities of Mesolithic north-west Europe (broadly defined as c.9300 cal. BC to c.4000 cal. BC). Instead, the period is perhaps most well known for some of the earliest inhumation cemeteries in northern Europe, the most familiar being the Scandinavian sites of Skateholm I and II (Scania, Sweden) (Larsson 1988a) and Vedbæk-Bøgebakken (Zealand, Denmark) (Albrethsen and Brinch Petersen 1977) and those on the coast of northern France, Teviéc and Hoëdic (Morbihan, France) (Péquart et al. 1937; Péquart and Péquart 1954). As concentrations of well-furnished burials they have long provided the focus for discussions of Mesolithic mortuary practice as well as social status and group organization (e.g. Clark and Neeley 1987) and, more recently, cosmology (e.g. Zvelebil 2003), personhood (e.g. Fowler 2004), sexuality (e.g. Schmidt 2000) and the ritual practice of handling the body (e.g. Nilsson Stutz 2003). However, discoveries within the last two decades have increased the evidence for the practice of cremation (as well as other forms of treatment, such as secondary burial) amongst the huntergatherers of the Mesolithic, both in terms of the geographic distribution of the practice and its temporal spread throughout the period. Although rare in comparison to inhumation, cremation can now be seen to have been practiced throughout both the early and late Mesolithic and, whilst evidence is currently sparse within the modern areas of Germany and the British Isles, examples are known across Scandinavia, the Netherlands, Belgium, northern France, and the Republic of Ireland (totalling at least thirteen sites with cremated remains amongst over 100 sites with human bone in this area, see Fig. 2.1 and Table 2.1). Additionally, whilst preparing this chapter, a new discovery of cremated remains deposited in a large pit was made at Langford (Essex, England) and directly dated to the late Mesolithic, representing the first example from England (Gilmour and Loe 2015). It is worth noting here that there are also several more sites with human remains (usually disarticulated or ‘loose’ human bones) which are described as ‘charred’ or ‘burnt’ but for the purposes of this chapter I consider ‘cremated remains’ to refer to bone or a body that has undergone the mortuary rite of cremation (transformation of a corpse by burning) and burnt bone as the incidental or deliberate burning of dry and/or disarticulated bone (after McKinley 2013: 150).
Interpretation of Burned Remains: Lessons from Modern Forensic Cases
Authors: Ubelaker Douglas H.
Published: November 2020

Experimentation regarding thermal effects on human bone provides valuable information that is needed to interpret ancient remains as well as modern forensic cases. Applications of this information in the forensic arena often clarify key issues in case interpretation. The forensic experience also contributes to the knowledge available on thermal effects on bone, by using information gleaned from the cases. Thus, forensic casework involves a two-way academic street of information flow. General knowledge of thermal effects is needed to interpret particular problems presented by the cases. Resolution of cases, with disclosure of the circumstances leading to the thermal effects, yields valuable information that enhances methodology and diagnoses of future applications. Problems presented by forensic casework can also stimulate new research and subsequently enhance methodology. Although forensic analysis has traditionally been applied to individual cases brought to the laboratory, increasingly forensic anthropologists are involved in recovery and analysis issues of complex cases, including those involving mass fatalities (Sledzik and Rodriguez 2002; Sledzik 2009). These can include aeroplane crashes, military incidents, civil strife, terrorist activities, natural disasters, and other events, which produce fatalities with associated thermal alterations. Forensic anthropologists provide a vital service in the recovery and interpretation of evidence in the aftermath of such events. These unique experiences yield valuable information on the thermal effects on human remains. One lesson learned from such experience is that advanced thermal conditions can lead to extensive fragmentation of bones and teeth (McKinley 1989; Ubelaker 2009). A classic well-known product of thermal exposure on a human body is the pugilistic pose involving contraction of the muscles of the arms producing those limbs positioned as if in the boxer’s position (Saukko and Knight 2004). This position, involving the legs as well as the arms, is commonly encountered when most soft tissue is preserved and the heat is of low duration and intensity. In such cases, the bones may escape alteration via protection by the soft tissue. If the heat is prolonged and extensive, the soft tissue will probably be burned away, exposing the underlying bone. This process may produce varying bone exposure, depending on the position of the individual and other factors (Fairgrieve 2008).
Pathways for the Dead in the Middle and Late Bronze Age in Ireland
Authors: Cooney Gabriel
Published: November 2020

Because of its diversity and visibility the mortuary record of the Early Bronze Age (2400–1500 cal. BC) has long dominated interpretation of that period in Ireland (e.g. Cooney and Grogan 1994; Waddell 1998; Brindley 2007) and burials from Bronze Age cemeteries represent over 70 per cent of the burial record from Irish prehistory (Murphy et al. 2010). The explosion of development-funded excavation in the period from the mid-1990s to the mid-2000s provided a settlement balance to that picture and also evidence for additional cemeteries (e.g. Grogan et al. 2007; McQuade et al. 2009). This suggests that Early Bronze Age cemeteries served as local foci for communities. From the evidence of the numbers interred over a number of generations the dead buried in the cemeteries represent what Mary Helms (1998) has usefully called the ‘distinguished dead’ from communities, not the entire population. Treatment of the dead within the cemeteries is complex and there are clear indications of change over time. Interpretative models had associated inhumation with males and a broader shift over time from inhumation to cremation relying on a view of cremation and inhumation as opposed, separate mortuary rites (e.g. Mount 1997). However, the evidence indicates a much more complex set of pathways in the postmortem treatment of the dead in which cremation and inhumation were employed as complementary mortuary rites with an increasing focus on cremation over time (e.g. Cahill and Sikora 2011). This new picture has important implications for the increasing significance of the the pyre and the transformation of the dead (Mizoguchi 1993: 232). In looking at the period after 1500 cal. BC we see continuity in aspects of mortuary practice and use of sites, but in other ways mortuary practice changed dramatically. Cremation is now the dominant mortuary rite. Burial in the Middle and Late Bronze Age (down to 600 cal. BC) has been widely discussed as less visible, and hence much less important as an aspect of social behaviour (e.g. Cooney and Grogan 1994: 144). But it is more useful to think in terms of shifting emphases in mortuary practice. In a recent discussion Lynch and O’Donnell (2007: 107) have described this period as being characterized by ‘an incredibly intricate and variable physical treatment of the dead’.
Basic Immunology
Authors: Lambourne Jonathan , Buchanan Ruaridh
Published: November 2020

There are four major components of the immune system. These include: 1. mechanical barriers to pathogen entry. 2. the innate immune system. 3. the adaptive immune system. 4. the lymphoid organs. Mechanical barriers include skin and mucous membranes and tight junctions between epithelial cells prevent pathogen entry. Breaches can be iatrogenic, for example, IV lines, surgical wounds, and mucositis, and are a large source of healthcare- associated infections. The innate immune system provides the first internal line of defence, as well as initiating and shaping the adaptive immune response. The innate system comprises a range of responses: phagocytosis by neutrophils and macrophages (guided in part by the adaptive immune system), the complement cascade, and the release of antimicrobial peptides by epithelial cells (e.g. defensins, cathelicidin). The adaptive immune system includes both humoral (antibody- mediated) and cell-mediated responses. It is capable of greater diversity and specificity than the innate immune system, and can develop memory to pathogens and provide increased protection on re-exposure. Immune cells are divided into myeloid cells (neutrophils, eosinophils, basophils, mast cells, and monocytes/macrophages) and lymphoid cells (B, T, and NK cells). These all originate in the bone marrow from pluripotent haematopoietic stem cells. The lymphoid organs include the spleen, the lymph nodes, and mucosal-associated lymphoid tissues—which respond to antigens in the blood, tissues, and epithelial surfaces respectively. The three main ‘professional’ phagocytes are macrophages, dendritic cells, and neutrophils. They are similar with respect to how they recognize pathogens, but differ in their principal location and effector functions. Phagocytes express an array of Pattern Recognition Receptors (PRRs) e.g. Toll-like receptors and lectins (proteins that bind carbohydrates). PRRs recognize Pathogen- Associated Molecular Patterns (PAMPs)— elements which are conserved across species, such as cell-surface glycoproteins and nucleic acid sequences. Though limited in number, PRRs have evolved to recognize a huge array of pathogens. Binding of PRRs to PAMPs enhances phagocytosis. Macrophages are tissue-resident phagocytes, initiating and co-ordinating the local immune response. The cytokines and chemokines they produce cause vasodilation and alter the expression of endothelial cell adhesion factors, recruiting circulating immune cells.
The Concept of Chain of Infection and Infection Control Principles
Authors: Jacob George , Cummins Martina N.
Published: November 2020

For an infectious agent to spread to cause disease, certain conditions must be present. This process is called the chain of infection, which consists of six links: ● Causative agent; ● Infectious reservoir; ● Path of exit; ● Mode of transmission; ● Path of entry; and ● Susceptible host. Infection can occur when all six links are intact. By breaking this chain, the spread of infection can be stopped. ● Causative agent A micro- organism capable of causing infection is called a causative agent. Most commonly they are bacteria, viruses, fungi, and parasites. ● Infectious reservoir A reservoir of infection is the source from which infection can spread by allowing the pathogen to survive and possibly multiply. Humans, animals, and even inanimate environmental objects can serve as reservoirs of infection. There are many sources of infection in a healthcare setting. These include patients, healthcare workers, visitors, inanimate objects like medical equipment, and even the hospital environment. A human reservoir can be either an infected case, or a carrier, i.e. the person is colonized by a particular pathogen and does not present with any symptoms or signs of acute infection. Adherence to standard infection control practices is important as these asymptomatic carriers present a risk of cross infection, especially in healthcare surroundings. ● Path of exit The path of exit is how a pathogen leaves its reservoir. It normally refers to the site where the micro- organism grows. Common sites of exit associated with human reservoirs include the skin, mucous membranes, and the respiratory, gastrointestinal, and genitourinary tracts. ● Mode of transmission The mode of transmission is the route by which an infection spreads. Certain pathogens may use more than one route of transmission from reservoir to host. There are three common modes of transmission. This is the most common mode of infection transmission in a healthcare setting. It can occur either through direct contact when there is direct physical contact with the patient or indirect contact when the pathogen is transmitted from a contaminated intermediate object. Infection spreads through the airborne route when the susceptible person inhales infected particles in droplet nuclei of less than 5 μm.
Immunotherapy
Authors: Lambourne Jonathan , Buchanan Ruaridh
Published: November 2020

Immunotherapy implies the use of an immune-based therapy to treat infection. Broadly speaking, these therapies can be divided into antibody-based therapies (both pathogen specific and pathogen agnostic), cellular therapies (e.g. CMV-specific T cells), and immune signalling therapies (e.g. interferon-alpha in the treatment of hepatitis C infection). While agents such as corticosteroids, thalidomide, and vitamin D have profound effects on immune function and a well-established role in the treatment of some infections (e.g. corticosteroids in tuberculous and pneumococcal meningitis), in this review they are not considered as immunotherapy, as they are not directly derived from components of the immune system. When considering immunotherapy, it is important to make a distinction between therapy and prophylaxis. There are well-established indications for using immunotherapy as prophylaxis against infection, including the use of varicella immune globulin and RSV-specific monoclonal antibodies (Palivizumab) to prevent chicken pox and RSV infection respectively. In addition, immunization is a form of immunotherapy—inducing a primary immune response and immunological memory such that on exposure to the pathogen, a secondary immune response is rapidly generated, hopefully leading to the control and eradication of the pathogen before infection occurs. There are few immunotherapies currently in routine clinical use, and several experimental therapies under investigation. The aim of most immunotherapy is to replicate what should happen in an effective immune response to a pathogen, but which, due to host factors, pathogen factors, or both, has failed to occur. Antibodies exert their effect in three main ways: 1. Neutralization: Antibody binding to pathogens, or their toxins, limits the access of the pathogen or the toxin to the target cell, thereby preventing cell infection or damage. Neutralization is important for preventing viral entry into cells and preventing the actions of bacterial toxins, e.g. Staphylococcal exotoxin. Neutralization cannot prevent bacterial replication. 2. Antibody dependent cytotoxicity: Phagocytes express receptors for the Fc-portion of antibodies on their cell surface (FcRs). Ligation of phagocyte FcR with an antibody bound to a pathogen is an effective method of delivering a pathogen to a phagocyte for engulfment and destruction. Coating of pathogens with antibodies is a form of opsonization, or ‘making ready to eat’.
Perioperative medicine
Authors: Whymark Caroline , Junkin Ross , Ramsey Judith
Published: November 2020

To pass the written part of the FRCA, candidates must achieve the pass mark for the SAQs and the MCQ/ SBA papers combined. Therefore, doing particularly well in one paper, or one area, can compensate for another in which you have scored poorly. The 30 SBA questions is an area that candidates commonly find difficult. There is a feeling these questions are unjust and that it is impossible to second guess the examiners and choose the correct option. They feel further punished that four marks are awarded for each correct answer or lost for an incorrect choice. While this reflects the fact that four answers have been eliminated in the course of choosing the best answer, candidates often state it is an unfair ‘all or nothing’ way to mark these questions. They can commonly narrow the choice down to a final two options but report finding it difficult to then choose between them. They receive no credit having successfully eliminated three of the options and cite the SBA element as being the reason they failed the examination. These comments however are not supported by examination success data published by the RCoA. The pass rate for this paper was consistent at around 70% before and after the introduction of the SBA component in September 2011. We believe the concepts behind the SBAs are misunderstood by many. When asked to write a SBA question, candidates inevitably produce a five- part A to E multiple choice question but with only one correct answer. The finer points of SBA questions are lost among quickly written revision aids containing what the authors believe to be examination standard questions, when often they are not. Further, because SBAs are a relatively new element to the FRCA there is a limited bank of questions, and a highly restricted number in the public domain. Both these factors make practice of these questions difficult. Part of exam success is practice of the technique and question type in advance. We believe the practice of SBAs is an area to which candidates do not give enough attention.
ENT, maxillofacial, and ophthalmology
Authors: Whymark Caroline , Junkin Ross , Ramsey Judith
Published: November 2020

To pass the written part of the FRCA, candidates must achieve the pass mark for the SAQs and the MCQ/ SBA papers combined. Therefore, doing particularly well in one paper, or one area, can compensate for another in which you have scored poorly. The 30 SBA questions is an area that candidates commonly find difficult. There is a feeling these questions are unjust and that it is impossible to second guess the examiners and choose the correct option. They feel further punished that four marks are awarded for each correct answer or lost for an incorrect choice. While this reflects the fact that four answers have been eliminated in the course of choosing the best answer, candidates often state it is an unfair ‘all or nothing’ way to mark these questions. They can commonly narrow the choice down to a final two options but report finding it difficult to then choose between them. They receive no credit having successfully eliminated three of the options and cite the SBA element as being the reason they failed the examination. These comments however are not supported by examination success data published by the RCoA. The pass rate for this paper was consistent at around 70% before and after the introduction of the SBA component in September 2011. We believe the concepts behind the SBAs are misunderstood by many. When asked to write a SBA question, candidates inevitably produce a five- part A to E multiple choice question but with only one correct answer. The finer points of SBA questions are lost among quickly written revision aids containing what the authors believe to be examination standard questions, when often they are not. Further, because SBAs are a relatively new element to the FRCA there is a limited bank of questions, and a highly restricted number in the public domain. Both these factors make practice of these questions difficult. Part of exam success is practice of the technique and question type in advance. We believe the practice of SBAs is an area to which candidates do not give enough attention.
Cardiothoracics
Authors: Whymark Caroline , Junkin Ross , Ramsey Judith
Published: November 2020

To pass the written part of the FRCA, candidates must achieve the pass mark for the SAQs and the MCQ/ SBA papers combined. Therefore, doing particularly well in one paper, or one area, can compensate for another in which you have scored poorly. The 30 SBA questions is an area that candidates commonly find difficult. There is a feeling these questions are unjust and that it is impossible to second guess the examiners and choose the correct option. They feel further punished that four marks are awarded for each correct answer or lost for an incorrect choice. While this reflects the fact that four answers have been eliminated in the course of choosing the best answer, candidates often state it is an unfair ‘all or nothing’ way to mark these questions. They can commonly narrow the choice down to a final two options but report finding it difficult to then choose between them. They receive no credit having successfully eliminated three of the options and cite the SBA element as being the reason they failed the examination. These comments however are not supported by examination success data published by the RCoA. The pass rate for this paper was consistent at around 70% before and after the introduction of the SBA component in September 2011. We believe the concepts behind the SBAs are misunderstood by many. When asked to write a SBA question, candidates inevitably produce a five- part A to E multiple choice question but with only one correct answer. The finer points of SBA questions are lost among quickly written revision aids containing what the authors believe to be examination standard questions, when often they are not. Further, because SBAs are a relatively new element to the FRCA there is a limited bank of questions, and a highly restricted number in the public domain. Both these factors make practice of these questions difficult. Part of exam success is practice of the technique and question type in advance. We believe the practice of SBAs is an area to which candidates do not give enough attention.
Obstetrics
Authors: Whymark Caroline , Junkin Ross , Ramsey Judith
Published: November 2020

To pass the written part of the FRCA, candidates must achieve the pass mark for the SAQs and the MCQ/ SBA papers combined. Therefore, doing particularly well in one paper, or one area, can compensate for another in which you have scored poorly. The 30 SBA questions is an area that candidates commonly find difficult. There is a feeling these questions are unjust and that it is impossible to second guess the examiners and choose the correct option. They feel further punished that four marks are awarded for each correct answer or lost for an incorrect choice. While this reflects the fact that four answers have been eliminated in the course of choosing the best answer, candidates often state it is an unfair ‘all or nothing’ way to mark these questions. They can commonly narrow the choice down to a final two options but report finding it difficult to then choose between them. They receive no credit having successfully eliminated three of the options and cite the SBA element as being the reason they failed the examination. These comments however are not supported by examination success data published by the RCoA. The pass rate for this paper was consistent at around 70% before and after the introduction of the SBA component in September 2011. We believe the concepts behind the SBAs are misunderstood by many. When asked to write a SBA question, candidates inevitably produce a five- part A to E multiple choice question but with only one correct answer. The finer points of SBA questions are lost among quickly written revision aids containing what the authors believe to be examination standard questions, when often they are not. Further, because SBAs are a relatively new element to the FRCA there is a limited bank of questions, and a highly restricted number in the public domain. Both these factors make practice of these questions difficult. Part of exam success is practice of the technique and question type in advance. We believe the practice of SBAs is an area to which candidates do not give enough attention.
Gurob: Luxury Goods Manufacture in a Harbour and Palace City
Authors: Hodgkinson Anna   K.
Published: November 2020

The site of Gurob lies in the south-eastern section of the Faiyum region, on a desert plain, adjacent to the fertile land. It is located in the area that would have formed the entrance to the Faiyum in the New Kingdom. As with Amarna, it has also been possible to undertake a spatial analysis for Gurob, at least with the material recorded in recent years through the work of the active mission. Artefactual evidence from previous missions, such as Petrie’s and Hughes-Hughes’, was also considered, but can only be discussed with regard to its nature, as precise find locations were, unfortunately, not recorded. Gurob, like Amarna, can be regarded as an atypical settlement. The palace, which is this site’s main element, has been interpreted as a harem palace, the dwelling of the ladies belonging to the royal household. A variety of Ramesside papyri making reference to high officials belonging to the royal harem of Mer-Wer (translated as ‘the Great Canal’) form the largest group of evidence of this interpretation. Other factors in this connection are the purchase of the famous head of Queen Tiye by Borchardt, as well as the very frequent finding of clay woman-on-bed figurines by the present mission, which probably had a place in ritual activities. Gurob, with its position at the entrance to the Faiyum in the New Kingdom, would have played an important role for trade and diplomacy in the area. Despite its somewhat specialized function the settlement has been included in this analysis, as it was occupied for a considerable amount of time and thus represents a valid example of a New Kingdom royal city. Petrie excavated at Gurob for two seasons, in 1888 and in 1889–90. He excavated in the cemeteries, but mainly in the palace buildings and enclosure, as well as the area he initially interpreted as a temple. The majority of finds from his excavations are in the Petrie Museum of Egyptian Archaeology, London, although only about forty finds can be regarded with certainty as having come from Gurob.
Numerical solution methods
Authors: Fehr Hans , Kindermann Fabian
Published: November 2020

In this chapter we develop simple methods for solving numerical problems. We start with linear equation systems, continue with nonlinear equations and finally talk about optimization, interpolation, and integration methods. Each section starts with a motivating example from economics before we discuss some of the theory and intuition behind the numerical solution method. Finally, we present some Fortran code that applies the solution technique to the economic problem. This section mainly addresses the issue of solving linear equation systems. As a linear equation system is usually defined by a matrix equation, we first have to talk about how to work with matrices and vectors in Fortran. After that, we will present some linear equation system solving techniques.
Life-cycle choices and risk
Authors: Fehr Hans , Kindermann Fabian
Published: November 2020

The optimal savings and investment decisions of households along the life cycle were a central issue in Chapter 5. There, savings decisions were made under various forms of risks.However, we restricted our analysis to three period models owing to the limitations of the numerical all-in-one solution we used. In this chapter we want to take a different approach. Applying the dynamic programming techniques learned so far allows us to separate decision-making at different stages of the life cycle into small sub-problems and therefore increase the number of periods we want to look at enormously. This enables us to take amuchmore detailed look at how life-cycle labour supply, savings, and portfolio choice decisions are made in the presence of earnings, investment, and longevity risk. Unlike in Chapter 9, the models we study here are partial equilibrium models. Hence, all prices as well as government policies are exogenous and do not react to changes in household behaviour. This chapter is split into two parts. The first part focuses on labour supply and savings decisions in the presence of labour-productivity and longevity risk. Insurance markets against these risks are missing, such that households will try to self-insure using the only savings vehicle available, a risk-free asset. This model is a quite standard workhorse model in macroeconomics and a straightforward general equilibrium extension exists, the overlapping generations model, which we study in Chapter 11. In the second part of the chapter, we slightly change our viewpoint and look upon the problem of life-cycle decision-making from a financial economics perspective. We therefore exclude laboursupply decisions, but focus on the optimal portfolio choice of households along the life cycle, when various forms of investment vehicles like bonds, stocks, annuities, and retirement accounts are available. This section is devoted to analysing consumption and savings behaviour when households face uncertainty about future earnings and the length of their life span. We study how households can use precautionary savings in a risk-free asset as a means to selfinsure against the risks they face. While in our baseline model we assume that agents always work full-time, we relax this assumption later on by considering a model with endogenous labour supply as well as a model with a labour-force participation decision of second earners within a family context.
Does itt Work?
Authors: Metcalfe David , Dev Harveer
Published: November 2020

Improving Selection to the Foundation Programme (ISFP) undertook a wide- ranging review of options for allocating new doctors to FY1 posts. It selected the SJT. Whether the SJT works or not depends on whether it can accurately predict ‘good’ doctors. There is no real consensus about how to measure the effectiveness of foundation doctors, and so the SJT question is unlikely to ever be resolved to everyone’s satisfaction. However, variations on the SJT have been used in selection to some specialties (e.g. general practice (GP) and public health training). They are also used by many firms in the commercial sector. The SJT pilots suggested a high degree of internal reliability (α = 0.79– 0.85). It was also shown that SJT performance is positively correlated with extraversion, openness, and achievement. A subsequent study (MacKenzie et al. 2017) has shown that SJT score was predicted by emotional non- defensiveness, aloofness, and empathy, as suggested by the non- cognitive component of the UK Clinical Aptitude Test (UKCAT). The SJT score is also correlated with UKFPO performance (MacKenzie et al. 2016). Interestingly, SJT score is not correlated with performance at medical school as measured by the EPM (Simon et al. 2015). Advantages of the SJT over the previously used ‘white space’ questions include the following: ● invigilated conditions so that no one can seek external help with answers ● less reliance on creative writing skills ● questions directly address prioritization, teamworking, and professionalism— all of which are important qualities for new doctors ● evidence from other sectors suggests that situational judgement questions can effectively predict job performance. Although students are unlikely to relish sitting another high- stakes examination in their final year, earlier selection methods were perceived as both burdensome and unfair. A number of studies have suggested that the SJT is unpopular amongst both medical students and faculty members (Sharma, 2015; Sharma et al. 2016). It is impossible to please everyone and you are most likely to approve of this method in retrospect if your score is high enough. Criticisms of the SJT include: ● As noted on, the SJT and EPM are not equally weighted.
Tips for the SJT
Authors: Metcalfe David , Dev Harveer
Published: November 2020

1. Put yourself in the position of a new FY1 doctor when answering each question. But remember that they are asking what you should do, not what you would do. 2. You should be a paragon of virtue when answering all questions. Remember always that you are unfailingly honest, respectful, open, and fair to colleagues, patients, and relatives alike. It is difficult to imagine scenarios with answers that would require you to be otherwise. 3. If a question involves patient safety (e.g. critically unwell patient, drug error, etc.), your priority must always be making the patient safe. 4. The well- being of your patient is your first priority. Other considerations (e.g. relatives, targets, fear of being told off, going home on time) are always secondary. 5. ‘Seeking senior advice’ and ‘gathering information’ are difficult to criticize and tend to be safe options. Similarly, it is rarely incorrect to document events or complete a formal incident form. 6. Remember your limitations. As an FY1 doctor, you should not usually break bad news, consent patients for operations, administer cytotoxic or anaesthetic drugs, or manage critically ill patients without support. ‘Call a senior’ is the correct answer in these cases. 7. Understand basic concepts of medical law, e.g. when confidentiality can be breached, determining incapacity, consent in children, the doctrine of double effect, and detention under the Mental Health Act. You do not need to know specifics (e.g. sections of Acts), but a practical understanding will guide some answers. 8. As an FY1 doctor, your Clinical Supervisor is usually a consultant for whom you work during a particular rotation. They are an appropriate source of support for clinical development and problems within the team. Your Educational Supervisor is akin to a Personal Tutor, i.e. responsible for your overall welfare and development throughout the year. They can advise on pastoral issues, professional development, and difficulties with your Clinical Supervisor. 9. Try to complete all questions within the given time frame as random guesses may be identified by the scoring software and awarded zero.