Planning for incapacity by people with bipolar disorder under the Mental Capacity Act 2005

The Mental Capacity Act 2005 provided a variety of legal mechanisms for people to plan for periods of incapacity for decisions relating to personal care, medical treatment, and financial matters. Little research has however been done to determine the degree to which these are actually implemented, and the approach to such advance planning by service users and professionals. This paper looks at the use of advance planning by people with bipolar disorder, using qualitative and quantitative surveys both of people with bipolar disorder and psychiatrists. The study finds that the mechanisms are under-used in this group, despite official policy in support of them, largely because of a lack of knowledge about them among service users, and there is considerable confusion among service users and professionals alike as to how the mechanisms operate. Recording is at best inconsistent, raising questions as to whether the mechanisms will be followed

Case Study - IPv6 based building automation solution integration into an IPv4 Network Service Provider infrastructure

The case study presents a case study describing an Internet Protocol (IP) version 6 (v6) introduction to an IPv4 Internet Service Provider (ISP) network infrastructure. The case study driver is an ISP willing to introduce a new “killer” service related to Internet of Things (IoT) style building automation. The provider and cooperation of third party companies specialized in building automation will provide the service. The ISP has to deliver the network access layer and to accommodate the building automation solution traffic throughout its network infrastructure. The third party companies are system integrators and building automation solution vendors. IPv6 is suitable for such solutions due to the following reasons. The operator can’t accommodate large number of IPv4 embedded devices in its current network due to the lack of address space and the fact that many of those will need clear 2 way IP communication channel. The Authors propose a strategy for IPv6 introduction into operator infrastructure based on the current network architecture present service portfolio and several transition mechanisms. The strategy has been applied in laboratory with setup close enough to the current operator’s network. The criterion for a successful experiment is full two-way IPv6 application layer connectivity between the IPv6 server and the IPv6 Internet of Things (IoT) cloud

National school chaplaincy and student welfare program guidelines

The National School Chaplaincy Program is a voluntary program that assists school communities to support the spiritual, social, and emotional wellbeing of their students. This can include support and guidance about ethics, values, relationships and spirituality; the provision of pastoral care; and enhancing engagement with the broader community. Commencing in January 2012, the Program builds upon the success of the National School Chaplaincy Program and supports school communities to establish school chaplaincy and student welfare services or to enhance existing services. The major changes to the Program include: a new title for the Program choice of support worker minimum qualification requirements for funded school chaplains/student welfare workers improved complaints handling mechanisms an increase in the maximum grant for schools in remote locations and minimum standards for funding recipients

Assessment innovation and student experience: a new assessment challenge and call for a multi-perspective approach to assessment research

The impact of innovative assessment on student experience in higher education is a neglected research topic. This represents an important gap in the literature given debate around the marketization of higher education, international focus on student satisfaction measurement tools and political calls to put students at the heart of higher education in the UK. This paper reports on qualitative findings from a research project examining the impact of assessment preferences and familiarity on student attainment and experience. It argues that innovation is defined by the student, shaped by diverse assessment experiences and preferences and therefore its impact is difficult to predict. It proposes that future innovations must explore assessment choice mechanisms which allow students to shape their own assessments. Cultural change and staff development will be required to achieve this. To be accepted, assessment for student experience must be viewed as a complementary layer within a complex multi perspective model of assessment which also embraces assessment of learning, assessment for learning and assessment for life long learning. Further research is required to build a meta theory of assessment to enhance the synergies between these alternative approaches and to minimise tensions between them

Using participatory, practice development, Delphi and realist research approaches to understand how frontline teams can use the workplace to make sustainable improvements in the quality of their practice

The symposium will share the approaches and findings from three funded national and international research studies which all contribute to the body of knowledge about how to support person centred, safe and effective care in the workplace. The final presentation will integrate the theoretical insights emerging from the three studies to present a model for sustainable transformation in frontline teams. Paper 1 Safety culture, quality improvement, realist evaluation Authors and affiliations Professor Kim Manley CBE, (Presenter), Carolyn Jackson, Christine McKenzie, Anne Martin, Dr Toni Wright. Abstract Safety in health care is an international concern with impact on quality of care (Hollnagel, et al, 2015). A Regional Patient Safety Collaborative (PSC), one of 15 nationally set up to place patients, carers and staff at the heart of quality improvements in patient safety, supported four large acute NHS hospital trusts with a PSC model to help facilitators use safety and quality improvement tools with frontline teams and to be mutually supported through action learning. The evaluation used realistic evaluation (Pawson & Tilley, 2004) (and the study and its findings are reported using the RAMESES 11 international standards (Wong et al, 2017). The study took place between June 2016-October 2017. Its aim was to understand what works for whom 3S.40-5.10pm1 Symposia- – Tuesday 17 April 2018 and why, when: working with frontline teams in large acute hospitals to embed a safety culture, and grow leadership and quality improvement capability. Specifically, to identify which strategies are effective in supporting front line teams to sustain bottom up change and quality improvement driven by the needs of patients and practitioners. The study drew on ethnographic principlesacross study sites usingdescriptive case study design. Mixed methods of critical observation of frontline practice, stakeholder evaluation,emotional touch points, self-assessment;qualitative 360 degree feedback; and the Texas safety culture survey tool were used to facilitate the development of a rich picture for each teamand each context so as to answer the evaluation questions. In tandem, interrogation of the literature to distilled relationships between context, mechanisms and outcomes generating hypotheses at individual, team and organisational level factors for safety culture. Key findings identified an interdependence between clinical leadership within frontline teams, safety culture, safety behaviours and teamwork echoed in microcosm through safety huddles; the skills and attributes of facilitators;and the impact of organisations on microsystems. Theories of culture change at the microsystems level are further embellished. References Hollnagel E., Wears R.L. and Braithwaite J. From Safety-I to Safety II: A White Paper. The Resilient Health Care Net: Published simultaneously by the University of Southern Denmark, University of Florida, USA, and Macquarie University, Australia. http://citeseerx.ist.psu.edu/viewdoc/download doi=10.1.1.911.6550&rep=rep1&type=pdf (accessed 1st November 2017) Pawson, R. & Tilley, N. (2004) Realist Evaluation. [Online]. Available at: . Accessed: 14th November 2014. Wong, G.; Westhorp, G.; Greenhalgh, J.; Manzano, A.; Jagosh, J.; Greenhalgh, T, (2017) Quality and reporting standards, resources, training materials and information for realist evaluation: the RAMESES II project. Health Services and Delivery Research, 5(28) National Institute for Health Research October ISSN 2050-4349 DOI 10.3310/ Paper 2 Developing integrated facilitation standards to embrace the facilitation of learning in the workplace using e-Delphi Authors and affiliations Professor Kim Manley CBE, (Presenter), Carolyn Jackson, Anne Martin, Dr Toni Wright. Abstract This paper shares insights into the impact of system wide leadership initiatives that develop the facilitation capacity of the workforce to be effective clinical leaders in a time of increasingly complex system wide change (Manley et al, 2016, Crisp & Wilson 2011). The aim of this Delphi study (2015-16), was to develop a set of standards that could be used to guide an integrated approach to facilitation in and about the workplace. This includes the key qualities and skills required of facilitators who aim to integrate learning, development, improvement, inquiry, knowledge translation and innovation in and about the workplace. The study influenced by the knowledge base underpinning practice development methodology engaged international facilitation expertise. Three e-Delphi rounds involved participants from ten countries with expertise in facilitating either one or more of the purposes in work and/or about the workplace. The result, a set of standards builds on the current knowledge base about facilitation. The standards clarify the key components that facilitators need to attend to when supporting individuals, teams, organisations and services to achieve higher order learning in and about the workplace and positively impact on person centred cultures and health outcomes. The contribution of practice development as a discipline that integrates all the agendas was highlighted and needs to be promoted more explicitly at the policy level. The key messages from this work are that: Facilitators work within different contexts and help staff appreciate the broader contexts in which they work. These contexts impact on both facilitator and staff purposes within and across each context. An integrated approach to facilitation aims to support a number of purposes. Enablers, skills and strategies for achieving these purposes are identified in the set of standards developed Facilitators need to attend to the evaluation of outcome and impact in the given context whilst keeping focus on constantly refining the processes that are effective. References Crisp, J., & Wilson, V. (2011). How do facilitators of practice development gain the expertise required to support vital transformation of practice and workplace cultures? Nurse Education in Practice, 11(3), 173-178. Manley, K., Martin, A., Jackson, C., & Wright, T. (2016). Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study. BMC Health Services Research, 16(1), 1 Paper 3 Developing theoretical insights into sustainable transformation in front line teams – the Venus model Authors and affiliation Carolyn Jackson, Director, England Centre for Practice Development, Canterbury Christchurch University, UK (Presenter), Professor Kim Manley CBE, Anne Martin, DrToni Wright. Abstract Definitions for continuous Professional Development (CPD) tend to focus on individual objectives, yet the goals of CPD activity are mutually interdependent on individual and system aspects (Billet, 2002) This paper presents the theoretical and practical insights gathered from a realist synthesis and evaluation (2014-2015) that led to a tool designed to measure the impact of learning on individual, team and organisational effectiveness in relation to improvements in quality of care and patient outcomes in the workplace. The aim of the project was to develop and test a CPD Impact Tool that identifies mechanisms for measuring the impact of learning on individual, team and organisational effectiveness and the indicators useful for providing information on individual and team effectiveness in relation to outcomes in the workplace? The study used mixed methods across two phases with different stakeholder groups to first develop theories about the relationship between contexts, mechanisms and outcomes for CPD to help understand which strategies work best for whom in what circumstance and why? Phase 1 methods included: a literature review, underpinned by 12 critical questions, to identify what is known about CPD across three broad themes 1) What is CPD is and why it is important? 2) Purpose and impact of CPD, and 3) Facilitating and Judging the Effectiveness of CPD. This together with a stakeholder surveyanalysis and documentary analysis of CPDlearning outputs informed the development of the CPD framework and indicators which was then further tested in phase 2 with CPD providers, learner and an expert international reference group. Key findings centre on four transformation theories that underpin an overarching framework for understanding effective CPD and a set of Impact indicators for guiding evaluation In order for CPD to be effective it has to address all of the interdependent outcomes for individual, team, service and organisational transformation. Reference Billett S. Critiquing Workplace Learning Discourses: Participation and Continuity at Work. Stud Educ Adults. 2002; 34(1):56-67. Paper 4 Developing theoretical insights into sustainable transformation in front line teams – the Venus model Authors and affiliation Carolyn Jackson, Director, England Centre for Practice Development, CanterburyChristchurch University, UK (Presenter), Professor Kim Manley CBE. Abstract This paper presents a synthesis of the theoretical insights emerging from the three research studies together with outputs from a workshop for an international network of fellows. This synthesis is presented as a theoretical framework – the Venus Model for sustainable person centered transformation. This framework describes the key elements and linked concepts (and relationships) required to support front line teams (micro-systems) transform practice through interprofessional learning, development, improvement and innovation, and the essential organisational and systems factors required to enable this. The five key elements of the model are 1) supporting development of facilitation skills across a continuum of complex purposes, 2) leadership development at clinical to systems levels, 3) practice development - a complex methodology that focuses on collaborative, inclusive and participative approaches with stakeholders,to develop person-centred, safe and effective cultures, 4) using quality improvement skills and tools, and 5) the culture change skills at the front line of practice. Bottom up, as opposed to top down models for supporting complex change in organisations are crucial to understand how to transform systems, services and cultures of care within and across organisations to deliver new models for 21st century health and well-being. The symposium will conclude by sharing implications for practice based research and inquiry, workforce development and new emergent roles by considering how best to support and evidence the contribution of nurses to the future workforce on a global platform. This will include consideration of how nurses can take a leadership roles in both the delivery and evaluation of sustainable transformation across the health economy to impact on future new models of care

Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

<p>Abstract</p> <p>Background</p> <p>Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH.</p> <p>Methods</p> <p>Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis.</p> <p>Results</p> <p>Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications.</p> <p>Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills, strategies that promote evidence-based practice and managerial leadership skills.</p> <p>Conclusions</p> <p>Although there are numerous barriers to delivery of quality health services at MNRH, many barriers could be addressed by strengthening the relationship between the Hospital and MakCHS. Strategic partnerships and creative use of existing resources, both human and financial, could improve the quality of care and service delivery at MNRH. Improving services and providing more skills training could better prepare MakCHS graduates for leadership roles in other health care facilities, ultimately improving health outcomes throughout Uganda.</p

USING AUDIENCE-CENTRIC DESIGN AND COMMUNITY FEEDBACK TO MANAGE COMPLEX PRIVACY SETTINGS

Today, technology is enabling people to share information on an unprecedented scale. Although much of this information is intended to be shared with a large group of people or even the public, some disclosure is intended for smaller audiences—a subset of a larger group. People may want to limit information visibility because the information is private or sensitive, or they may feel others would not be interested in the content. When people want to selectively share to different audiences, many technologies fail to provide usable mechanisms to manage these more complex sharing situations. In many cases, people lack understanding about which audiences are able to see what items of information. Additionally, the effort to manage audiences and control access to information adds some extra physical and cognitive burden. This research suggests two methods to help people better understand and control sharing. The first examines audience-centric design: using mechanisms that integrate with the primary task and allow sharing to multiple audiences to improve understanding of how information flows to multiple groups of people. The second method examines using community feedback to enhance privacy/sharing default settings thereby lessening the user’s configuration burden. This knowledge contributes to existing research by understanding the extent of how users share information to multiple audiences and react to community feedback mechanisms designed to ease configuration burden

Distributed-Proof-of-Sense: Blockchain Consensus Mechanisms for Detecting Spectrum Access Violations of the Radio Spectrum

The exponential growth in connected devices with Internet-of-Things (IoT) and next-generation wireless networks requires more advanced and dynamic spectrum access mechanisms. Blockchain-based approaches to Dynamic Spectrum Access (DSA) seem efficient and robust due to their inherited characteristics such as decentralization, immutability and transparency. However, conventional consensus mechanisms used in blockchain networks are expensive to be used due to the cost, processing and energy constraints. Moreover, addressing spectrum violations (i.e., unauthorized access to the spectrum) is not well-discussed in most blockchain-based DSA systems in the literature. In this work, we propose a newly tailored energyefficient consensus mechanism called “Distributed-Proof-of-Sense (DPoS)” that is specially designed to enable DSA and detect spectrum violations. The proposed consensus algorithm motivates blockchain miners to perform spectrum sensing, which leads to the collection of a full spectrum of sensing data. An elliptic curve cryptography-based zero-knowledge proof is used as the core of the proposed mechanism. We use MATLAB simulations to analyze the performance of the consensus mechanism and implement several consensus algorithms in a microprocessor to highlight the benefits of adopting the proposed system

IIoT Data Ness: From Streaming to Added Value

In the emerging Industry 4.0 paradigm, the internet of things has been an innovation driver, allowing for environment visibility and control through sensor data analysis. However the data is of such volume and velocity that data quality cannot be assured by conventional architectures. It has been argued that the quality and observability of data are key to a project’s success, allowing users to interact with data more effectively and rapidly. In order for a project to become successful in this context, it is of imperative importance to incorporate data quality mechanisms in order to extract the most value out of data. If this goal is achieved one can expect enormous advantages that could lead to financial and innovation gains for the industry. To cope with this reality, this work presents a data mesh oriented methodology based on the state-of-the-art data management tools that exist to design a solution which leverages data quality in the Industrial Internet of Things (IIoT) space, through data contextualization. In order to achieve this goal, practices such as FAIR data principles and data observability concepts were incorporated into the solution. The result of this work allowed for the creation of an architecture that focuses on data and metadata management to elevate data context, ownership and quality.O conceito de Internet of Things (IoT) é um dos principais fatores de sucesso para a nova Indústria 4.0. Através de análise de dados sobre os valores que os sensores coletam no seu ambiente, é possível a construção uma plataforma capaz de identificar condições de sucesso e eventuais problemas antes que estes ocorram, resultando em ganho monetário relevante para as empresas. No entanto, este caso de uso não é de fácil implementação, devido à elevada quantidade e velocidade de dados proveniente de um ambiente de IIoT (Industrial Internet of Things)