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This article contributes to current debates about professional doctorates from a lifelong learning perspective, focusing on those who choose to undertake a doctoral programme in mid- or late career and their responses to the challenge of demonstrating their ‘doctorateness’ as evidenced in their previous and continuing professional work. It is based on the first 10 case histories of an extensive grounded theory study of the 150 candidates who have so far presented themselves for the professional doctorate of Middlesex University (UK) and reveals some insights into the pedagogical processes that come into play when people are given centre stage in the design and completion of doctoral programmes based on their own professional work. Central to those processes is the extent to which, in response to that responsibility, candidates successfully demonstrate their professionalism at the highest level within critical academic and professional environments. In accordance with grounded theory we conclude with some ...

The concept of Return on Investment (ROI) in training has hitherto been largely associated with the corporate world where Kirkpatrick's model of training evaluation is widely used. Interest in Kirkpatrick is growing in the public sector. This article examines how the Kirkpatrick model is actually used in a range of commercial organisations and reports that, despite the continuing respect for the model as a whole, there are few examples of organisations moving beyond Kirkpatrick's first level evaluation. Using a grounded theory analysis of interviews with over 40 key decision-makers in a variety of businesses, the article explores what practitioners believe to be important when judging the overall effectiveness of training, and presents a five-stage holistic model for evaluating ROI based on their views and experience. The article concludes with some thoughts on the possible applicability of the five-stage model to the evaluation of public sector education and training initiatives.

This paper presents the outcomes of a systematic review of the experience of the first cohorts using Ufi's online Learning through Work (LtW) facility to negotiate personalized programmes of study leading to full university awards based on projects related to their everyday work. The concept of learning through work and wider experience of online work-based learning are discussed, and the main features of the LtW programme are described. Data are drawn from user surveys and in-depth interviews of participants. A grounded theory methodology is used to allow propositions to emerge from the data about user readiness, institutional responses and wider impact on the learners and their work-place. These propositions are presented for discussion in the wider context of learner-managed learning and the use of the Internet for university-recognized learning through work.

Previous notes in this series have been concerned with the common situation in ophthalmic and other clinical fields of describing relationships between one or more ‘predictors’ (explanatory variables) and, usually, one outcome measure (response variable). A classic method used in deriving relationships between outcomes and predictors is linear regression analysis. Linear regression is a member of a family of techniques known as general linear models, which also include analysis of variance and analysis of covariance; the latter of which was covered in a previous Ophthalmic Statistics Note.1 A key feature of all these models is that the outcome measure—for example, postoperative refractive prediction error or intraocular pressure—is continuous. While other notes in the series2 warn of the dangers of unnecessary dichotomisation of variables, sometimes outcomes naturally fall into two categories. In both examples, our objective is to examine …

Latent inhibition (LI) is a model of attention, which is a cognitive process that can be modulated by stressors such as chronic intermittent broadband noise, e.g. caused by building work, which is particularly stressful to rats. The aim of this study was to analyse the effect of chronic noise stress, caused by a building project, on LI, and its interaction with SR 46,349B, a 5-HT2A receptor antagonist. Control groups from LI experiments conducted during periods of chronic intermittent noise were compared with control groups from LI experiments conducted in normal quiet conditions. The interaction of SR 46,349B with the effects of chronic noise stress was then tested. Chronic intermittent noise attenuated LI, an effect which was partially reversed by SR 46,349B, 2.4 mg/kg i.p. Attenuation of LI by chronic intermittent noise and reversal of this effect by SR 46,349B support suggestions that stress can modulate attention and that 5-HT2A receptors are involved in mediating the effects of chronic stress.

Following transection of peripheral nerve, rats exhibit autotomy, which is considered to be the animal model of postdenervation pain syndrome. It has been suggested that phantom limb pain is a result of peripheral denervation leading to reorganization of somatosensory pathways, particularly in the cerebral cortex, which is shown to depend upon central noradrenergic activity. In this study, sciatic and saphenous nerves were sectioned in the left hindpaw of 30 adult rats resulting in complete loss of pain sensation in the hindpaw. A group of rats received normal saline, compared to another group which received N-(2-) Chloroethyl-N-ethyl-2-bromobenzylamine (DSP4) injection 24 h prior to transection. The latter group was also compared to a third group whose central noradrenergic system were also blocked by bilateral injection of 6-OHDA into the ascending noradrenergic bundle 1 week prior to transection. A fourth group received contralateral cortical ablation in addition to peripheral nerve transection and was compared to the first group whose cortex remained intact. The animals were observed daily for 60 days and autotomy was scored in accordance to the system of Wall et al. [42]. After 1 week, control animals began to exhibit autotomy. In contrast, autotomy was absent in rats treated with DSP4, similar to rats which received 6-OHDA. Rats which had contralateral cortical ablation showed a considerably delayed onset of autotomy and a reduction in final autotomy scores. We conclude that autotomy, as a model of postdenervation pain syndrome, can be prevented by blockade of noradrenergically mediated cortical reorganization. The clinical implications of this finding are discussed.

Aim The aim of this research was to identify healthcare teaching staff’s understanding of spirituality, how their understanding may shape teaching practice and how this may contribute to the documented issues around incorporating spirituality into patient assessment and care. Method A mixed-method, small-scale explorative online survey was used. Findings Several perceptions and practices were identified that led to a better understanding of the obstacles to teaching in this area. Suggestions were made about how to shape teaching spirituality to improve patients’ experience and ensure spirituality is integrated more fully into assessment and care. Conclusion This study brought a better understanding of obstacles to integrating spirituality into teaching for healthcare lecturers and offered some ideas on how to best address these obstacles.

The aim of this study was to evaluate mental health and learning disability nursing students' perceptions of the usefulness of the objective structured clinical examination (OSCE) in assessing their administration of medicine competence. Learning disability (n = 24) and mental health (n = 46) students from a single cohort were invited to evaluate their experience of the OSCE. A 10-item survey questionnaire was used, comprising open- and closed-response questions. Twelve (50%) learning disability and 32 (69.6%) mental health nursing students participated. The OSCE was rated highly compared to other theoretical assessments; it was also reported as clinically real and as a motivational learning strategy. However, it did not rate as well as clinical practice. Content analysis of written responses identified four themes: (i) benefits of the OSCE; (ii) suggestions to improve the OSCE; (iii) concern about the lack of clinical reality of the OSCE; and (iv) OSCE-induced stress. The themes, although repeating some of the positive statistical findings, showed that participants were critical of the university setting as a place to conduct clinical assessment, highlighted OSCE-related stress, and questioned the validity of the OSCE as a real-world assessment. The OSCE has an important role in the development of student nurses' administration of medicine skills. However, it might hinder their performance as a result of the stress of being assessed in a simulated environment.

Background: Patients often experience problems using metered dose inhalers (MDIs), particularly poor coordination between inhalation start and dose actuation (TsIn: time difference between the start of an inhalation and the actuation of a dose), and fast peak inspiratory flow (PIF). We investigated if a coordination cap (CAP), with instruction to prolong inhalation, solved these problems. Methods: Inhalation profiles [PIF, TsIn, inhalation volume (Vi), inhalation time (Ti)] of patients with stable asthma prescribed an MDI were measured using their real-life technique (MDI). Inhalation profiles were then measured with the cap fitted (MDI+CAP). These patients were then instructed to inhale through the MDI+CAP for 5 sec, and inhalation profiles measured (MDI+CAP+TRAIN). TsIn was only measured for the MDI. Results: Resistances of MDI and MDI+CAP were 0.0135 and 0.0243 (cm H2O)½/(L/min), respectively. Seventy-one patients were evaluated, with mean [standard deviation (SD)] forced expiratory volume over 1 sec % predicted normal of 78.3% (21.0). Following MDI, MDI+CAP, and MDI+CAP+TRAIN: mean (SD) PIF was 155.6 (61.5), 112.3 (48.4), and 73.8 (34.9) L/min, respectively (p

An oxygen-inserted quasi-planar segmented channel MOSFET design is proposed and studied for monolithic system-on-chip applications. Projections indicate that it will provide for higher performance than bulk FinFET technology at the 10 nm node, due to higher field-effect carrier mobility, lower source/drain series resistance, and the benefit of super-steep retrograde well punchthrough-stopper doping.

Background\ud Breast reconstruction is safe and improves quality of life. Despite this, many women do not undergo breast reconstruction and the reasons for this are poorly understood. This study aims to identify the factors that influence a woman's decision whether or not to have breast reconstruction and to better understand their attitudes toward reconstruction.\ud \ud Methodology\ud An online survey was distributed to breast cancer patients from Breast Cancer Network Australia. Results were tabulated, described qualitatively and analyzed for significance using a multiple logistic regression model.\ud \ud Results\ud 501 mastectomy patients completed surveys, of which 62% had undergone breast reconstruction. Factors that positively influenced likelihood of reconstruction included lower age, bilateral mastectomy, access to private hospitals, decreased home/work responsibilities, increased level of home support and early discussion of reconstructive options. Most common reasons for avoiding reconstruction included “I don't feel the need” and “I don't want more surgery”. The most commonly sited sources of reconstruction information came from the breast surgeon followed by the plastic surgeon then the breast cancer nurse and the most influential of these was the plastic surgeon.\ud \ud Conclusions\ud A model using factors easily obtained on clinical history can be used to understand likelihood of reconstruction. This knowledge may help identify barriers to reconstruction, ultimately improving the clinicians' ability to appropriately educate mastectomy patients and ensure effective decision making around breast reconstruction.

Purpose\ud The purpose of this study was to validate the Oswestry Spinal Risk Index (OSRI) in an external population. The OSRI predicts survival in patients with metastatic spinal cord compression (MSCC).\ud \ud Methods\ud We analysed the data of 100 patients undergoing surgical intervention for MSCC at a tertiary spinal unit and recorded the primary tumour pathology and Karnofsky performance status to calculate the OSRI. Logistic regression models and survival plots were applied to the data in accordance with the original paper.\ud \ud Results\ud Lower OSRI scores predicted longer survival. The OSRI score predicted survival accurately in 74% of cases (p = 0.004).\ud \ud Conclusions\ud Our study has found that the OSRI is a significant predictor of survival at levels similar to those of the original authors and is a useful and simple tool in aiding complex decision making in patients presenting with MSCC

Background: The characteristics of each inhalation maneuver when patients use dry powder inhalers (DPIs) are important, because they control the quality of the emitted dose.\ud \ud Methods: We have measured the inhalation profiles of asthmatic children [CHILD; n=16, mean forced expiratory volume in 1 sec (FEV1) 79% predicted], asthmatic adults (ADULT; n=53, mean predicted FEV1 72%), and chronic obstructive pulmonary disease (COPD; n=29, mean predicted FEV1 42%) patients when they inhaled through an Aerolizer, Diskus, Turbuhaler, and Easyhaler using their “real-life” DPI inhalation technique. These are low-, medium-, medium/high-, and high-resistance DPIs, respectively. The inhalation flow against time was recorded to provide the peak inhalation flow (PIF; in L/min), the maximum pressure change (ΔP; in kPa), acceleration rates (ACCEL; in kPa/sec), time to maximum inhalation, the length of each inhalation (in sec), and the inhalation volume (IV; in liters) of each inhalation maneuver.\ud \ud Results: PIF, ΔP, and ACCEL values were consistent with the order of the inhaler's resistance. For each device, the inhalation characteristics were in the order ADULT>COPD>CHILD for PIF, ΔP, and ACCEL (p4 L and ΔP >4 kPa.\ud \ud Conclusion: The large variability of these inhalation characteristics and their range highlights that if inhalation profiles were used with compendial in vitro dose emission measurements, then the results would provide useful information about the dose patients inhale during routine use. The inhalation characteristics highlight that adults with asthma have greater inspiratory capacity than patients with COPD, whereas children with asthma have the lowest. The significance of the inhaled volume to empty doses from each device requires investigation.

Aim\ud The aim of this project was to develop and deliver an evidence-based educational package with a physical and mental health focus to clinicians and other health care workers in mental health settings.\ud \ud Background\ud For individuals who experience mental disorders, pharmacotherapy is often considered as a first line of treatment. However, owing to adverse drug reactions and pre-existing physical conditions, outcomes for clients/service users may be compromised. Mortality and morbidity rates of people diagnosed with a serious mental illness caused by physical health conditions do not compare favourably with the general population. This paper reports on a physical skills project that was developed in collaboration between the University of Huddersfield and South West Yorkshire Partnership Foundation Trust.\ud \ud Method\ud Pre–post study design: five workshops were conducted in the fields of intramuscular injections, diabetes, health improvement, oral health and wound care. A total of 180 pairs of questionnaires to assess practitioner and student skills and knowledge were administered to participants before and after workshops. All workshops resulted in a statistically significant improvement in subject skills and knowledge scores (P < 0.001 in all cases). Questionnaires also elicited participant satisfaction with the workshops: over 99% of participants reported being ‘satisfied’ or ‘very satisfied’ with the workshops.\ud \ud Implications for nursing management\ud Mental health nurses are the largest group of registered practitioners working in the mental health setting and thus need to be harnessed to make a positive contribution to the improvement of the physical health status of service users with a serious mental illness.

Dysfunction in the dopaminergic and serotonergic neurotransmitter systems has been demonstrated to be important in the etiology of borderline personality disorder (BPD). We investigated the relationship of two BPD risk factors, the HTR1A promoter polymorphism -1019C > G (rs6295) and the dopamine transporter (DAT1) repeat allele, with BPD in a major depressive disorder cohort of 367 patients. Out-patients with major depressive disorder were recruited for two treatment trials and assessed for personality disorders, including BPD. DNA samples were collected and the rs6295 polymorphism was detected with a TaqMan® assay. The DAT1 repeat allele was genotyped using a modified PCR method. The impact of polymorphisms on BPD was statistically analyzed using uncontrolled logistic and multiple logistic regression models. BPD patients had higher frequencies of the DAT1 9,9 (OR = 2.67) and 9,10 (OR = 3.67) genotypes and also those homozygous HTR1A G allele (OR = 2.03). No significant interactions between HTR1A and DAT1 genotypes, were observed; however, an increased risk of BPD was observed for those patients who were either 9,10; G,G (OR = 6.64) and 9,9; C,G (OR = 5.42). Furthermore, the odds of BPD in patients exhibiting high-risk variants of these two genes differed from those of patients in low-risk groups by up to a factor of 9. Our study provides evidence implicating the importance of the serotonergic and dopaminergic systems in BPD and that the interaction between genes from different neurotransmitters may play a role in the susceptibility to BPD.

The reorganisation of primary somatosensory cortex that occurs after lesioning the corresponding cortex of the contralateral hemisphere in rat has been termed, 'transhemispheric cortical reorganisation'. Cholinergic and noradrenergic innervations are hypothesized to be involved in cortical plasticity. The present study investigated the change in responses of somatosensory neurones in the hindpaw representation area to muscarinic cholinoceptor and beta-adrenoceptor receptor stimulation, by iontophoretic application of acetylcholine, noradrenaline, propranolol and atropine, during the process of transhemispheric cortical reorganization at 3-4 days and at 20-21 days after lesioning the corresponding area in the contralateral hemisphere. Most neurones in control rats showed excitatory atropine-sensitive responses to acetylcholine, and inhibitory propranolol-sensitive responses to noradrenaline. A marked reduction in neurones exhibiting muscarinic responses (from 69% to 22%) and beta-noradrenoceptor-mediated responses (from 62% to 24%) were seen in rats 3-4 days post lesion. The proportion of neurones responding had recovered by 3 weeks but the direction of the responses had changed with muscarinic response becoming predominantly inhibitory and beta-noradrenoceptor responses predominantly excitatory. It is concluded that transhemispheric cortical reorganization involves both receptor types and that the reciprocal changes at different stages after injury maintain cortical plasticity.

Episodic ataxia type 1 (EA1) is an autosomal dominant central nervous system potassium channelopathy characterized by brief attacks of cerebellar ataxia and continuous interictal myokymia. Point mutations in the voltage-gated potassium channel gene KCNA1 on chromosome 12p associate with EA1. We have studied 4 families and identified three new and one previously reported heterozygous point mutations in this gene. Affected members in Family A (KCNA1 G724C) exhibit partial epilepsy and myokymia but no ataxic episodes, supporting the suggestion that there is an association between mutations of KCNA1 and epilepsy. Affected members in Family B (KCNA1 C731A) exhibit myokymia alone, suggesting a new phenotype of isolated myokymia. Family C harbors the first truncation to be reported in KCNA1 (C1249T) and exhibits remarkably drug-resistant EA1. Affected members in Family D (KCNA1 G1210A) exhibit attacks typical of EA1. This mutation has recently been reported in an apparently unrelated family, although no functional studies were attempted. Heterologous expression of the proteins encoded by the mutant KCNA1 genes suggest that the four point mutations impair delayed-rectifier type potassium currents by different mechanisms. Increased neuronal excitability is likely to be the common pathophysiological basis for the disease in these families. The degree and nature of the potassium channel dysfunction may be relevant to the new phenotypic observations reported in this study.

This article is concerned primarily with university‐related work‐based learning in the UK. The authors trace the development of work‐based learning from its early days to the wide variety of styles and scale currently being practised. In the wake of the Dearing Report, they review the experience of work experience and sandwich courses; the move from work experience to work‐based learning; work‐based learning for those in work; and work‐based learning through technological transfer. The authors identify key variables which appear to determine the nature of different styles of work‐based learning including the tension between the twin purposes of international competitiveness and student personal development, and the willingness of the universities to move from their traditional control of the curriculum to allow a greater variety of learning experiences. The authors focus on the emergence of learner‐managed three‐way partnerships between the learner, the university, and the employer based on real‐...

Jeffrey B. Gibson, The Temptations of Jesus in Early Christianity, reviewed by Colleen Shantz Norman C. Habel, The Land Is Mine: Six Biblical Land Ideologies, reviewed by Marvin L. Anderson Thomas W. Gillespie, The First Theologians: A Study in Early Christian Prophecy, reviewed by Michael P. Knowles Richard A. Horsley, Galilee: History, Politics, People, reviewed by William E. Arnal Gareth Schmeling, ed., The Novel in the Ancient World, reviewed by Richard S. Ascough David C. Sim, Apocalyptic Eschatology in the Gospel of Matthew., reviewed by John S. Kloppenborg Jeffrey L. Staley, Reading with a Passion: Rhetoric, Autobiography, and the American West in the Gospel of John, reviewed by Willi Braun Carsten P. Thiede, Re-Kindling the Word: Jesus, Qumran and the Papyri, reviewed by Jean-Fran~ois Racine Lauri Thuren, The Motivation of the Paraenesis: Discovering Argumentation and Theology in 1 Peter, reviewed by Robert L. Webb Renita J. 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Reversible, controllable optical nanocontraction and dilatation in a chalcogenide glass film was induced by polarized light, and a direct correlation of this optomechanical effect with the reversible optical-induced optical anisotropy (dichroism) also exhibited by the chalcogenide glass was observed. A microscopic model of the photoinduced, reversible structural phenomenon responsible for the optomechanical behavior is presented. The ability to induce an anisotropic optomechanical effect could form the basis of a number of applications, including polarized light-dependent optical nanoactuators, optomechanical diaphragm micropumps, and even motors driven by polarized light.

Responses were evoked in the hippocampal CA1 field by stimulating the medial septal area (MSA) and ventral hippocampal commissure (VHC) of urethane-anaesthetized rats. Tetanic stimulation of the MSA resulted in a homosynaptic long-term potentiation (LTP) of a slow synaptic response in the hippocampus, and heterosynaptic LTP of the evoked VHC response. Both forms of LTP were blocked by MK801. Tetanization of the VHC resulted in homosynaptic LTP but did not produce heterosynaptic LTP of the evoked MSA response. Atropine pretreatment increased commissural homosynaptic LTP and unveiled a heterosynaptic LTP of MSA-evoked responses. In contrast, atropine pretreatment partially blocked the homosynaptic LTP produced by tetanization of the MSA and prevented the heterosynaptic LTP of VHC-evoked responses.

A combined atomic force microscope (AFM) and scanning near-field optical microscope (SNOM) has been constructed to obtain images under liquids. In this combined AFM-SNOM an inverted ac mode configuration is used where the AFM cantilever is driven by exciting acoustic modes of the liquid cell. Optical images of latex spheres on a cantilever have been obtained under perfluorononane, butanol, and water with a lateral resolution of 100 nm. Fluorescence images of latex spheres have been obtained under perfluorononane. The ability to image under liquids opens up a wide range of applications of near field optical microscopy in chemistry and biology.

Unilateral AMPA lesions of the nucleus basalis magnocellularis (nbm) produced a nearly complete loss of cholinergic markers in the ipsilateral frontal and parietal cortices with no recovery at 6 months. The loss was associated with compensatory increases in AChE-positive fibre density in the contralateral cortex, in ipsilateral cortical regions not receiving their cholinergic innervation from the nbm and in the size of cholinergic magnocellular neurones in the contralateral nbm. The hypertrophy and increase in AChE-positive fibre density were apparent at 4-6 weeks after lesion and increased with time. Cholinergic transplants to cholinergically deafferented cortex prevented development of the compensatory increases in AChE-positive fibre density and restored AChE-positive fibre density and ChAT activity to control levels in ipsilateral cholinergically deafferented regions, partially after 6-8 weeks and completely after 6 months. In contrast, when cholinergic grafts were placed into unlesioned cortex, axonal outgrowth was localized to the vicinity of the transplant and did not develop with time. These results support the concept that vacant synapses promote and direct axonal outgrowth from transplanted neurones and that grafted cholinergic neurones integrate into the lesioned forebrain cholinergic projections system and prevent the lesion-induced changes in AChE-positive fibre density and ChAT activity.

The previous articles in this series 4 , 9 have shown that unilateral AMPA lesions of the nucleus basalis magnocellularis (nbm) produced widepread morphological and functional changes to the forebrain cholinergic projection system that could be reversed by transplants of fetal cholinergic tissue. At earlier postgraft time points, the effects of cholinergic grafts were specific to the neocortical region (frontal or parietal cortex) into which the grafts were targeted. Here we report that nbm lesion-induced spatial learning and memory deficits in the Morris water maze were reversed at 6–8 weeks postsurgery only by cholinergic grafts placed in the frontal cortex or frontal and parietal cortices combined. Similar grafts to parietal cortex only and noncholinergic fetal transplants to any cortical site were ineffective. In contrast, using separate groups of animals, deficits in sensorimotor function could be reversed in only one measure (open field turning) by cholinergic transplants targeted to the parietal (somatosensory) cortex or frontal and parietal cortex combined. These behavioural dissociations demonstrate that the frontal cortical cholinergic innervation from the nbm is necessary for effective spatial cognitive performance.

This paper presents the pre- and post-test results of the outcomes of a workshop designed to increase learning disability and mental health nurses' knowledge and skill to undertake interventions for service users at risk of, or with a diagnosis of, type 2 diabetes. Health literacy is also discussed as a way of explaining why such nurses may lack expertise in physical health care. Findings from the workshop show that learning disability and mental health nurses have the motivation to increase their health literacy (skills and knowledge) in diabetes care. The potential of such workshops, and how organisations looking forward to the future can build health literacy, is discussed.

Background context\ud Previous studies have shown that modern intraoperative blood-saving techniques dramatically reduce the allogeneic transfusion requirements in surgery for adolescent idiopathic scoliosis (AIS). No studies have looked at the pattern of postoperative hemoglobin (Hb) in AIS patients undergoing corrective spinal surgery and correlated this with the timing of allogeneic transfusion.\ud Purpose\ud To describe the pattern of perioperative blood loss in instrumented surgery for AIS. We look at the recommendations regarding an ideal preoperative Hb, the need for preoperative cross-matching, and the timing of postoperative Hb analysis.\ud \ud Study design\ud This was a retrospective case series. Surgeries were performed by one of four substantive pediatric spinal surgeons within a single regional center over a 3-year period.\ud \ud Patient sample\ud A consecutive series of 86 patients who underwent posterior instrumented fusion for AIS were included: 10 males and 76 females. Mean age was 14 years (range 10–17 years). All patients had posterior instrumented fusion using various blood-saving techniques (eg, cell-saver). All patients were cross-matched preoperatively, and our transfusion trigger value (TTV) was 7 g/dL.\ud \ud Outcome measures\ud Hemoglobin level was the outcome measure. Hemoglobin readings were obtained preoperatively, within 2 hours of surgery, and daily up to 5 days after surgery. This physiologic measure was assessed using routine blood sampling techniques and standardized laboratory processing.\ud \ud Methods\ud Patient predictor variables (demographic and surgical) were assessed for association with Hb levels in a hierarchical model, with repeated Hb readings at the lower level being clustered within an individual patient at the upper level of the structure. The variation of Hb levels within individuals was compared with mean levels in different individuals via the variance partition coefficient of the model structure.\ud \ud Results\ud No patients required intraoperative allogeneic transfusion. Only four patients (4.65%) received allogeneic transfusion, all within 2 days of surgery. A clinically important drop in Hb occurred within the first 2 postoperative days, rising thereafter. The average postoperative drop in Hb was 4.1 g/dL. Young males had lower postoperative Hb values. Neither the preoperative curve magnitude (Cobb angle of major curve) nor the number of vertebrae/levels fused significantly affected the blood loss.\ud \ud Conclusions\ud We recommend setting a minimum preoperative Hb value that is 5 g/dL higher than your TTV. Because no patients required an intraoperative transfusion when using modern blood-saving techniques, preoperative cross-matching is unnecessary and potentially wasteful of blood reserves. Hemoglobin analysis beyond the second postoperative day is unnecessary unless clinically indicated

Embedding capability in the curriculum building a learning community - developing an integrated strategy for the 21st century capabilities across the curriculum the TEC experience learner managed learning work-based learning and learning organisations development of skills and the career management initiative an institutional strategy for transferable skills and employability linking capability to levels and assessment an assessment topic capability through HE profiling, learning outcomes and learning contracts building a learning organisation through institutional capability the capability experience at Bournemouth University the partnership framework and personal and professional development independent study programmes and autonomous learning.

This is the second of two articles that focus on the inter-collaborative work, between education and practice, to enhance theoretical and practical delivery for mental health nurses when administrating long-acting antipsychotic injections (LAAIs). By designing two questionnaires, we were able to evaluate knowledge gain and the satisfaction level of the course delivery by the mental health nurses. These appear initially to identify that such educational strategies can make a positive impact in clinical practice.