Current thinking and practices in family life and sex education in the secondary schools of the United States.

Thesis (Ed.M.)--Boston Universit

Partnerships: Putting Governance Principles in Practice

This publication analyzes the research and project work of the Institute on Governance in civil society-government partnerships from the point of view of both players. The paper first explores the meaning of "governance" and "partnership"; then blends these concepts with good governance principles used by the UNDP and the Institute to create a tool for assessing good governance in partnership arrangements. Finally, the paper draws on the Institute's work in Canada and internationally, to illustrate some of the lessons and best practices in the governance of partnerships

Child Abuse and Neglect in the UK Today

This report presents new research findings from the NSPCC on child maltreatment in the United Kingdom, looking specifically at the prevalence and impact of severe maltreatment. We found that the rates of child maltreatment reported by young adults aged 18–24 were lower in 2009 than in 1998, suggesting maltreatment may be less prevalent today. However, significant minorities of children and young people in the UK today are experiencing severe maltreatment and this is associated with poorer emotional wellbeing, self-harm, suicidal ideation and delinquent behaviour

Modern innovative solutions to improve outcomes in severe asthma : Protocol for a mixed methods observational comparison of clinical outcomes in mission versus current care delivery

Background: Asthma that is poorly controlled and undertreated can progress to more severe disease that is associated with high levels of unscheduled care that requires high-cost therapy, leading to a significant health economic burden. The identification and appropriate referral to a specialist asthma service is also often delayed by several months or years because of poor recognition and understanding of symptom severity. Current severe asthma services may take several months to provide a comprehensive multidisciplinary assessment, often necessitating multiple hospital visits and costing up to £5000 per patient. Objective: This study aims to evaluate whether a new service model could identify poorly controlled and potentially severe asthma much earlier in the patient pathway, and then compare clinical outcomes between this new care model with standard care. Methods: Modern Innovative Solutions to Improve Outcomes in (MISSION) Severe Asthma is a novel service model developed by asthma specialists from Portsmouth and Southampton severe asthma services. MISSION Severe Asthma identified patients with poorly controlled disease from general practice databases who had not been under secondary outpatient care in the last 12 months or who were not known to secondary care. In 1- or 2-stop assessments, a thorough review of diagnosis, disease phenotype, and control is undertaken, and clinical outcomes collected at baseline. Results: A variety of clinical outcomes will be collected to assess the service model. The results will be reported in February 2020. Conclusions: This protocol outlines a mixed methods study to assess the impact on disease control, unscheduled health care usage, and quality of life in patients seen in the MISSION clinic compared with a closely matched cohort who declined to attend

Sustainable futures over the next decade are rooted in soil science

Funding information: Dutch Knowledge Base Program; European Commission, Grant/Award Number: NEW 810; Horizon 2020 Framework Programme, Grant/Award Numbers: 774378, 869625; Korea Environmental Industry and Technology Institute, Grant/Award Number: 2019002820004; Natural Environment Research Council, Grant/Award Number: NE/R016429/1; Svenska Forskningsrådet Formas, Grant/Award Number: 2017-00608; UK Research and Innovation, Grant/Award Number: NE/P019455/1Peer reviewedPublisher PD

Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults

Introduction: The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients. Methods: A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients. Results: Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than 0.6 with a percutaneous oxygen saturation more than 90% and a respiratory rate less than 30 breaths/minute were considered safe criteria for in- and out-of-bed mobilization if there were no other contraindications. At an international meeting, 94 multidisciplinary ICU clinicians concurred with the proposed recommendations. Conclusion: Consensus recommendations regarding safety criteria for mobilization of adult, mechanically ventilated patients in the ICU have the potential to guide ICU rehabilitation whilst minimizing the risk of adverse events

Call playback artificially generates a temporary cultural style of high affiliation in marmosets

Cultural variation can be conceptualised in two main ways: as culture-specific qualitative differences in behavioural form, and also as quantitative variation in performance of constellations of universal behaviours (cultural style). Despite observation of both types in wild non-human primates, diffusion of qualitative culture has been scrutinised extensively experimentally whilst within-species transmission of cultural style has remained entirely unexplored. Here we investigated whether a cultural style of high affiliation could be artificially generated in a nonhuman primate (Callithrix jacchus), by daily playback of conspecific affiliative calls simulating nearby amicable individuals. We found that vocalisation playback influenced monkeys to spend more time in affiliative behaviours outwith playback hours, relative to silent playback. The effect was specific to affiliation, with no impact on other categories of affect. This change did not persist into the final phase of observation after all playbacks were complete. Findings are consistent with a temporary shift in cultural style effected through vocalisation playback, supporting existence of this conception of culture in wild primates and indicating auditory social contagion as a potential diffusion mechanism. The method presented here will allow researchers to test hypotheses concerning cultural transmission of cultural style, and the underlying processes, across a range of contexts and species

BiCyCLE NMES—neuromuscular electrical stimulation in the perioperative treatment of sarcopenia and myosteatosis in advanced rectal cancer patients: design and methodology of a phase II randomised controlled trial

Abstract: Background: Colorectal cancer is associated with secondary sarcopenia (muscle loss) and myosteatosis (fatty infiltration of muscle) and patients who exhibit these host characteristics have poorer outcomes following surgery. Furthermore, patients, who undergo curative advanced rectal cancer surgery such as pelvic exenteration, are at risk of skeletal muscle loss due to immobility, malnutrition and a post-surgical catabolic state. Neuromuscular electrical stimulation (NMES) may be a feasible adjunctive treatment to help ameliorate these adverse side-effects. Hence, the purpose of this study is to investigate NMES as an adjunctive pre- and post-operative treatment for rectal cancer patients in the radical pelvic surgery setting and to provide early indicative evidence of efficacy in relation to key health outcomes. Method: In a phase II, double-blind, randomised controlled study, 58 patients will be recruited and randomised (1:1) to either a treatment (NMES plus standard care) or placebo (sham-NMES plus standard care) group. The intervention will begin 2 weeks pre-operatively and continue for 8 weeks after exenterative surgery. The primary outcome will be change in mean skeletal muscle attenuation, a surrogate marker of myosteatosis. Sarcopenia, quality of life, inflammatory status and cancer specific outcomes will also be assessed. Discussion: This phase II randomised controlled trial will provide important preliminary evidence of the potential for this adjunctive treatment. It will provide guidance on subsequent development of phase 3 studies on the clinical benefit of NMES for rectal cancer patients in the radical pelvic surgery setting. Trial registration: Protocol version 6.0; 05/06/20. ClinicalTrials.gov NCT04065984. Registered on 22 August 2019; recruiting