Metrics of student dissatisfaction and disagreement: longitudinal explorations of a national survey instrument.

This study explores dissatisfaction and neutrality metrics from 12 years of a national-level undergraduate student survey. The notion of dissatisfaction is much less prevalent in the narratives surrounding student survey outcomes, and the underpinning metrics are seldom considered. This is despite an increasingly vociferous debate about 'value for money' of higher education and the positioning of students as consumers in a marketised sector. We used machine learning methods to explore over 2.7 million national survey outcomes from 154 institutions to describe year-on-year stability in the survey items that best predicted dissatisfaction and neutrality, together with their similarity to known metric predictors of satisfaction. The widely publicised annual increases in student 'satisfaction' are shown to be the result of complex reductions in the proportions of disagreement and neutrality across different survey dimensions. Due to the widespread use of survey metrics in university league tables, we create an anonymised, illustrative table to demonstrate how UK institutional rankings would have differed if dissatisfaction metrics had been the preferred focus for reporting. We conclude by debating the tensions of balancing the provision of valuable information about dissatisfaction, with perpetuating negative impacts that derive from this important subset of the survey population.

Establishing funding rates for colonoscopy and gastroscopy procedures in Ontario.

Introduction: This paper describes the funding rates established in Ontario to reflect best practices in hospital-based care delivery for these endoscopic procedures: colonoscopy, colonoscopy biopsy, gastroscopy, gastroscopy biopsy, and colonoscopy combined with gastroscopy. Methods: The funding rates are based on direct costs and were established using a micro-costing approach after receipt of inputs from 3 working groups and a review of the administrative data and literature, where applicable. The first group advised on nursing activities, time, and staffing ratios along the patient pathway for each of the procedures. The second group provided recommendations about the duration for each procedure, and the third group provided information about supplies and equipment, their use, and costs. Results: The resulting funding rates are $161.18 for colonoscopy and $151.08 for gastroscopy (without accompanying interventions), $16.06 for colonoscopy biopsy and $8.22 for gastroscopy biopsy (added to the respective procedures), and $207.26 for combined colonoscopy and gastroscopy. Detailed costs for each component embedded in the rates are also provided. Conclusions: The rates came into effect in April 2018. The process and outcomes described here allowed for a transparent pricing mechanism in which funding follows the patient, clinical expert consensus is the basis for practice, and providers and payers both understand the components.

The wicked problem of healthcare student attrition.

The early withdrawal of students from healthcare education programmes, particularly nursing, is an international concern and, despite considerable investment, retention rates have remained stagnant. Here, a regional study of healthcare student retention is used as an example to frame the challenge of student attrition using a concept from policy development, wicked problem theory. This approach allows the consideration of student attrition as a complex problem derived from the interactions of many interrelated factors, avoiding the pitfalls of small-scale interventions and over-simplistic assumptions of cause and effect. A conceptual framework is proposed to provide an approach to developing actions to reduce recurrent investment in interventions that have previously proved ineffective at large scale. We discuss how improvements could be achieved through integrated stakeholder involvement and acceptance of the wicked nature of attrition as a complex and ongoing problem.

Comparing amber fossil assemblages across the Cenozoic.

To justify faunistic comparisons of ambers that differ botanically, geographically and by age, we need to determine that resins sampled uniformly. Our pluralistic approach, analysing size distributions of 671 fossilized spider species from different behavioural guilds, demonstrates that ecological information about the communities of two well-studied ambers is retained. Several lines of evidence show that greater structural complexity of Baltic compared to Dominican amber trees explains the presence of larger web-spinners. No size differences occur in active hunters. Consequently, we demonstrate for the first time that resins were trapping organisms uniformly and that comparisons of amber palaeoecosystem structure across deep time are possible.

Impact of cypermethrin on feeding behaviour and mortality of the spider Pardosa amentata in arenas with artificial 'vegetation'.

Pesticides can modify invertebrate movement and feeding behaviour which could reduce predation in agroecosystems. Previous assays have exposed the spider Pardosa amentata (Clerck) to the synthetic pyrethroid cypermethrin and monitored prey items consumed in small containers (requiring very little movement to capture prey). The current study used larger arenas containing artificial 'vegetation' (a plastic analogue) to encourage spiders to hunt and capture prey. The period 24 h after exposure produced greatest variability in prey item consumption between treatments and was used to examine treatment effects. At this time, cypermethrin reduced prey consumption rates but these effects did not persist. Findings did not suggest that the presence of artificial vegetation in arenas modified prey consumption rates, which was consistent for individuals treated with cypermethrin and a control group. This is despite the majority of pesticide-treated individuals exhibiting both ataxia and paralysis of the hind legs (these effects persisting for a maximum of 3 and 6 days respectively). These findings were consistent for both sexes. Spider longevity under starvation conditions was not significantly reduced by cypermethrin exposure but overall females survived longer than males. The findings are discussed in the context of the arenas used and the ecology of this common predator.