13 research outputs found

    Evaluation of the School Achievement Award Scheme (SAAS)

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    Employers skill survey : case study : health and social care

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    "This report examines the relationship between service delivery strategies and processes, and the deployment of skills, recruitment problems and skill gaps within selected sub-sectors of health and social care. The sub-sectors within health are physiotherapy and radiography. Within social care the focus is on care of the elderly (both residential and domiciliary care). Although subject to similar drivers and associated pressures, the two sub-sectors of health and social care display markedly different characteristics, particularly in terms of service delivery strategies, qualification frameworks and utilisation of skills. In simple terms, the health and social care subsectors considered within this report may be thought of as being situated at opposite poles of the ‘skills spectrum’: with radiography and physiotherapy characterised by high level skills, while care of the elderly is traditionally associated with low level skills. Hence, the two sub-sectors are discussed separately throughout this report. The greater complexity and range of skills required in the two health sub-sectors is reflected in the comparative length of the two sections of the report" - page 9

    Coastal natural and nature-based features: international guidelines for flood risk management

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    Natural and nature-based features (NNBF) have been used for more than 100 years as coastal protection infrastructure (e.g., beach nourishment projects). The application of NNBF has grown steadily in recent years with the goal of realizing both coastal engineering and environment and social co-benefits through projects that have the potential to adapt to the changing climate. Technical advancements in support of NNBF are increasingly the subject of peer-reviewed literature, and guidance has been published by numerous organizations to inform technical practice for specific types of nature-based solutions. The International Guidelines on Natural and Nature-Based Features for Flood Risk Management was recently published to provide a comprehensive guide that draws directly on the growing body of knowledge and practitioner experience from around the world to inform the process of conceptualizing, planning, designing, engineering, and operating NNBF. These Guidelines focus on the role of nature-based solutions and natural infrastructure (beaches, dunes, wetlands and plant systems, islands, reefs) as a part of coastal and riverine flood risk management. In addition to describing each of the NNBF types, their use, design, implementation, and maintenance, the guidelines describe general principles for employing NNBF, stakeholder engagement, monitoring, costs and benefits, and adaptive management. An overall systems approach is taken to planning and implementation of NNBF. The guidelines were developed to support decision-makers, project managers, and practitioners in conceptualizing, planning, designing, engineering, implementing, and maintaining sustainable systems for nature-based flood risk management. This paper summarizes key concepts and highlights challenges and areas of future research

    Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol

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    Introduction: Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area. We propose a randomised, controlled trial to establish the optimum method of timing delivery between 32 weeks and 36 weeks 6 days of gestation. We hypothesise that delivery on evidence of cerebral blood flow redistribution reduces a composite of perinatal poor outcome, death and short-term hypoxia-related morbidity, with no worsening of neurodevelopmental outcome at 2 years. Methods and analysis: Women with non-anomalous singleton pregnancies 32+0 to 36+6 weeks of gestation in whom the estimated fetal weight or abdominal circumference is <10th percentile or has decreased by 50 percentiles since 18-32 weeks will be included for observational data collection. Participants will be randomised if cerebral blood flow redistribution is identified, based on umbilical to middle cerebral artery pulsatility index ratio values. Computerised cardiotocography (cCTG) must show normal fetal heart rate short term variation (≥4.5 msec) and absence of decelerations at randomisation. Randomisation will be 1:1 to immediate delivery or delayed delivery (based on cCTG abnormalities or other worsening fetal condition). The primary outcome is poor condition at birth and/or fetal or neonatal death and/or major neonatal morbidity, the secondary non-inferiority outcome is 2-year infant general health and neurodevelopmental outcome based on the Parent Report of Children's Abilities-Revised questionnaire. Ethics and dissemination: The Study Coordination Centre has obtained approval from London-Riverside Research Ethics Committee (REC) and Health Regulatory Authority (HRA). Publication will be in line with NIHR Open Access policy. Trial registration number: Main sponsor: Imperial College London, Reference: 19QC5491. Funders: NIHR HTA, Reference: 127 976. Study coordination centre: Imperial College Healthcare NHS Trust, Du Cane Road, London, W12 0HS with Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University. IRAS Project ID: 266 400. REC reference: 20/LO/0031. ISRCTN registry: 76 016 200
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